抗菌药物致药疹65例临床分析

Clinical Analysis of 65 Cases with Drug Eruptions Caused by Antibacterial Agents

目的分析抗菌药物所致药疹的临床特点;探讨非重症药疹中糖皮质激素系统使用的合理性。方法对2011年4月-2018年4月收治65例抗菌药物所致药疹患者临床资料进行回顾性分析。结果在65例药疹中,青霉素类药物所致占29.2%(比例最高)。重症药疹和非重症药疹分别有10例和55例,其中发疹型药疹占36.9%(比例最高),而硝基咪唑类抗菌药所致药疹以固定型药疹多见。各类抗菌药所致药疹潜伏期多在7 d内。在皮损面积相对泛发的非重症药疹中系统使用糖皮质激素者皮损好转时间及住院时间较非激素治疗者更短,且差异有统计学意义,其中短期适量使用者无明显副作用。结论最常见的致敏药物为青霉素,发疹型药疹是最常见的药疹类型。在皮损相对泛发的非重症药疹中,早期适量系统使用糖皮质激素可以获得缩短病程的益处。

Objective To investigate the clinical features of antibacterial agents-induced drug eruptions, and to explore the rationality of the systematic use of glucocorticoids in non-severe drug eruptions caused by antibacterial agents. Methods Clinical data of 65 patients with drug eruptions caused by antibacterial agents from April 2011 to April 2018 were retrospectively analyzed. Results Among 65 cases of drug eruptions, 29.2% of the cases were caused by penicillins, which accounted for the highest proportion.There were 10 cases of severe drug eruptions and 55 cases of non-severe drug eruptions.The rash type of drug eruptions accounted for 36.9% as the highest proportion.Fixed drug eruptions were the most common type caused by nitroimidazole antibiotics.The incubation period of antibacterial agents-induced drug eruptions was within 7 days.In the non-severe drug eruptions with relatively extensive lesion area, patients with systemic glucocorticoid therapy had the shorter rash time and hospitalization time than non-glucocorticoid patients had, and the difference was statistically significant. Conclusion In this study, we identified that the most common drug eruptions caused by penicillins, and rash-type eruption was the most common drug eruption.In non-severe drug eruptions with a relatively wide area of rash, early and moderate uses of glucocorticoids could provide benefits in reducing duration of drug eruption thus reducing costs.