基于药品说明书解析β-内酰胺类抗生素皮肤过敏试验

Analysis of the dermal sensitivity test of β-lactam antibiotics based on dispensatory

目的:解析β-内酰胺类抗生素皮肤过敏试验现状,提出可行的建议,以保证用药安全。方法:收集我院现供应的45种β-内酰胺类抗生素的药品说明书,采用Excel 2003对其中皮肤过敏试验的警示内容进行归纳分析;同时结合文献,解析β-内酰胺类抗生素的皮试现状。结果:45种β-内酰胺类抗生素的药品说明书中,只有注射用盐酸头孢替安明确列出皮肤敏感试验方法;明确建议用药前应皮试的有16种药物,占药品总数的35.56%,包括4种注射用头孢菌素类药物、9种注射用青霉素类药物和3种口服青霉素类药物。目前国内对β-内酰胺类抗生素的皮试问题仍存在争议,国家卫生行政部门无统一规定,国内各医院的皮试方法也不尽相同。结论:为减少用药隐患,建议在使用β-内酰胺类抗生素前应详细询问患者的过敏史,严格按药品说明书要求谨慎使用,注射给药前应皮试。口服青霉素类药物给药前也应进行皮试。

Objective： To analyze the status quo of the dermal sensitivity test offl-lactam antibiotics and bring up feasible suggestion, in order to ensure the safe medication. Methods： A total of 45 dispensatories of β-lactam antibiotics used in our hospital were collected, and the contents about intradermal test were analyzed by Excel 2003. Simultaneously, literature data were reviewed to explore the status quo of the dermal sensitivity test of β-lactam antibiotics. Results： Among 45 dispensatories of β-lactam antibiotics, the procedure of intradermal test was only listed in the dispensatory of cefotiam hydrochloride for injection. It was recommended that intradermal test should be performed before medication in dispensatories of sixteen drugs （35.56%）, including four cephalosporins for injection, nine penicillins for injection and three oral penicillins. The question of whether or not taking the intradermal test of β-lactam antibiotics has been in debate. There are no unified rules made by the state public health administrative department. And there are different methods for intradermal test of β-lactam antibiotics in different hospitals. Conclusion： Before using β-lactam antibiotics, detailed history of allergy should be acquired firstly and the intradermal test is suggested to be performed before injection. As for oral penicillins, it is also necessary to perform the intradermal test before medication.