头孢菌素致16岁以下青少年儿童不良反应文献分析

An Analysis of the Literature on the Adverse Reactions of Cephalosporins in Children and Adolescents

目的:了解头孢菌素致16岁以下青少年儿童不良反应(ADR)的情况,探究其发生规律。方法:检索《中国医院数字图书馆》中有关头孢菌素引起ADR的文献资料(1994～2008),筛选收集16岁以下青少年儿童ADR的案例报告,按年龄、性别、给药途经、原患疾病、ADR发生时间、表现进行统计分析。结果:引起ADR的头孢菌素共有17种,居前三位的品种为头孢拉定(27.12%)、头孢噻肟(19.03%)、头孢哌酮(14.17%)。ADR在3～6岁的男孩(38.24%)和7～12岁的女孩(39.47%)中发生较多;变态反应(42.11%)、肝肾系统反应(28.34%)、神经系统反应(11.74%);血尿(25.91%)、过敏性休克(25.51%)、药疹(10.53%)是主要的临床表现;发生时间多为用药后30min内(34.41%)。过敏性休克多发于用药后10min内(58.73%)。头孢拉定引起的血尿最多(82.81%),头孢噻肟引起的过敏性休克最多(36.51%)。有6例死亡。结论:临床应重视头孢菌素在青少年儿童中引起的ADRs,警惕其严重ADRs(如过敏性休克、溶血)的发生,并鼓励、推广头孢菌素的皮试工作,以确保用药安全。

Objective：To explore the situation and rules of adverse drug reactions （ADRs） of cephalosporins in children and adolescents. Methods：The ADRs of 17 kinds of cephalosporins in children and adolescent from 247 cases,reported in CNKI database from 1994 to 2008,were collected and analyzed. Results：The top 3 cephalosporins inducing ADRs were cefradin （27.12% ）,cefotaxime （19.03% ） and cefoperazone （14.17%）. The percentage of male cases aged from 3 to 6 was 38.24% of all the male cases. The percentage of female cases aged from 7 to 12 was 39.47% of all the female cases. The clinical symptoms were occurred mainly in the allergy （42.11%）,liver and renal system （28.34%） and nervous system （11.74%）. The clinical manifestations of ADRs were hematuria（25.91%）,anaphylactic shock （25.51%） and drug eruption （10.53%）. The onset of ADRs was usually within 30 min after administration（34.41%）. The onset of anaphylatic shock was usually within 10 min after administration （58.73%）. Most of the hematuria induced by cephalosporins was caused by cefradine （82.81%）. Most of the anaphylatic shock induced by cephalosporins was caused by cefotaxime（36.51%） and 6 cases died. Conclusions：We should pay more attention to the ADRs of cephalosporins in children and adolescents,such as anaphylactic shock and hemolysis. The skin test of cephalosporins is of necessity and importance.