磷霉素致不良反应124例文献分析

Literature Analysis of 124 Cases of Fosfomycin-induced ADR

目的:探讨磷霉素致不良反应(ADR)发生的一般规律及特点,为临床合理用药提供参考。方法:以"磷霉素"为关键词,检索中国期刊全文数据库、万方数据库,收集磷霉素致ADR的有效文献99篇,共124例,并按患者性别、年龄、既往药物过敏史、原患疾病、用药情况、ADR发生时间、ADR类型及临床表现、评价与转归等进行分类、统计和回顾性分析。结果:124例磷霉素致ADR患者性别与年龄比较,无显著性差异(P>0.05);37例患者有药物及食物过敏史,占49.33%(75例患者有过敏史确切记录);121例(97.58%)患者经静脉滴注给药;过敏性休克最多(42例,33.87%),其次为皮肤及附件损害(28例,22.58%);出现ADR最快的是在静脉滴注后立即发生,最迟出现在患者用药5d后;绝大多数患者停药或治疗后好转恢复,死亡8例。结论:磷霉素致ADR的临床表现复杂多样,最严重的可能引起死亡,临床医师、药师应重视其ADR的危害性。

OBJECTIVE： To explore the general regularity and characteristics of adverse drug reactions （ADR） induced by fos- fomycin, and to provide reference for rational safe use of drugs in the clinic. METHODS： Using fosfomycin as key word, CNKI and Wangfang database were searched. A total of 99 literatures about fosfomycin-induced ADR were collected, involving 124 cases. The data were analyzed retrospectively in respect of patients＇ gender, age, allergy history, primary disease, medication, ADR on-set time, types and clinical manifestation of ADR, evaluation and outcome. RESULTS： There was no significant difference in patients＇ gender and age of 124 fosfomycin-induced ADR cases （P〉0.05）. 37 cases had drug and food allergy history, accounting for 49.33% （75 patients had exact record of allergy history）. 121 cases （97.58%） were given fosfomycin intravenously; the most of cases were anaphylactic shock （42 cases, 33.87% ）, followed by lesion of skin and its appendants （28 eases, 22.58% ）. The ear- liest ADR occurred the moment after intravenous dripping while the latest occurred in 5 days after administration. Most of ADR cas- es recovered when drug withdrawal or treatment were taken. However, there were 8 cases of death. CONCLUSION： ADRs induced by fosfomycin have many kinds of clinical manifestations with some death cases. Clinical doctors and pharmacists should pay more attention to the dangers of ADRs induced by fosfomycin.