48例阿莫西林致药疹住院病例分析

Analysis of 48 Cases of Drug Eruptions Induced by Amoxicillin

目的了解阿莫西林所致药疹的临床特征,为药品不良反应防治提供参考。方法分析某三甲医院2016年至2018年期间,因阿莫西林相关药疹收治住院患者的临床资料。结果 48例阿莫西林相关的药疹住院病例,涉及阿莫西林41例,阿莫西林克拉维酸钾7例。呼吸道感染、消化道幽门螺旋杆菌感染是主要的用药原因。患者平均年龄(42.94±20.78)岁,其中29.17%患者既往有阿莫西林或青霉素过敏史。药疹潜伏期在7 d内占86.67%,其中1 d以内占35.56%;平均住院日(8.42±4.83)d。住院期间使用糖皮质激素[以氢化可的松计,M(P25,P75)]1 580.00(625.00, 2 470.00) mg,使用阿莫西林与阿莫西林克拉维酸钾导致药疹的病例在住院日、糖皮质激素用量的差异无统计学意义(P=0.797, P=0.977);药疹患者有68.75%合并白细胞异常,有29.17%合并肝脏生化学检查异常。结论阿莫西林相关药疹潜伏期较短,及时诊治预后较好,需警惕血液系统异常以及肝损伤,使用阿莫西林需加强对患者过敏史的关注。

Objective To investigate the characteristics of amoxicillin-related drug eruptions and provide reference for the corresponding prevention and treatment of adverse drug reactions.Methods Analysis of inpatients admitted to a tertiary hospital between 2016 and 2018 for drug eruptions was conducted.Cases of amoxicillin-related drug eruptions were screened out,and patients'conditions and treatment outcomes were analyzed.The related data was obtained from the Hospital Information System(HIS).Results It was found that there were 48 cases of amoxicillin-related drug eruptions among the hospitalized patients,41 of which involved amoxicillin and 7 involved amoxicillin/clavulanate potassium.The mean age of the patients was 42.94±20.78 years old.Among them,14 patients had a previous history of allergy to amoxicillin or penicillin(29.2%).Respiratory tract infections and Helicobacter pylori infections were the main reason for medication.The incubation period of drug eruptions was within 1 day in 35.56%of the patients,and within 7 days in 86.67%of the patients after administration.The average length of hospital stay was 8.42±4.83 days,and cumulative dose of glucocorticoids(in terms of hydrocortisone)used during the hospital stay was 1580.00(625.00,2470.00)mg.There was no statistically significant difference in the length of hospital stay(P=0.797)or the cumulative dose of glucocorticoids(P=0.977)between cases of drug eruptions related to amoxicillin and amoxicillin/clavulanate potassium respectively.More patients were found to have abnormal levels of white blood cells(68.75%)and liver biochemical examination(29.17%).Conclusion The incubation period of amoxicillin-related drug eruptions is generally short,and it is within one week in most patients.There are no significant differences in severity and treatment outcomes of drug eruptions between amoxicillin and amoxicillin/clavulanate potassium.In case of drug eruptions,we need to be alert to blood system abnormalities and liver damage.Drug eruptions can have good prognosis after quick diagnosis and treatment.Attention must be paid to the patient's allergy history when such antibiotics as amoxicillin are prescribed.