比阿培南及枸地氯雷他定致皮疹1例

One case of exanthema induced by biapenem and desloratadine citrate disodium

1例81岁女性患者,因2型糖尿病、糖尿病性足溃疡、糖尿病性周围神经病变入院,既往无药物、食物过敏史。入院后予头孢地嗪(2.0 g,bid,ivgtt)治疗尿路感染及糖尿病足感染,6 d后由于抗感染治疗效果不佳,换用比阿培南(0.3 g,q 12 h,ivgtt),使用约4 h后患者胸腹部开始出现皮疹伴瘙痒,至夜间逐渐加重,考虑为比阿培南所致不良反应,予枸地氯雷他定(8.8 mg,qn,po)和炉甘石洗剂(适量,tid,外用)缓解过敏症状,并换用乳酸左氧氟沙星继续抗感染治疗,余治疗不变。7 d后,患者出现新发皮疹,考虑为枸地氯雷他定所致,立即停用该药,改用西替利嗪(10 mg,qn,po)联合地塞米松(5 mg,st,iv)抗过敏治疗,余治疗不变,患者皮疹逐渐好转,5 d后康复。

One 81-year-old female patient was hospitalized because of type 2 diabetes, diabetic foot and diabetic peripheral neuropathy. The patient had no history of medications and food allergies previously. Cefodizime （2.0 g, bid, ivgtt） was given for against infection of urinary tract infection and diabetic foot infection after admission. Due to the poor effect of anti-infection, the patient was administrated with biapenem （0.3 g, q 12 h, ivgtt）. About 4 h later, the patient appeared exanthema accompanied with itching, mainly in chest and abdomen regions. The symptoms increased gradually from afternoon to night, the adverse drug reaction was considered to be induced by biapenem, the patient was given desloratadine citrate disodium （8.8 mg, qn, po） and calamine lotion for relieving allergic symptoms, and the levofloxacin lactate was used to replace biapenem, complementary therapy remained the same. After 7 days, new exanthema reoccurred, the adverse drug reaction was considered to be induced by desloratadine citrate disodium, then the drug was stopped immediately, and patient was given cetirizine （10 mg, qn, po） and dexamethasone （5 mg, st, iv） for anti-allergic remedy, complementary therapy remained the same. Five days later, the exanthema improved gradually, and the patient got well again.