52例万古霉素致药物超敏反应综合征文献分析

Literature analysis of 52 cases of drug-induced hypersensitivity syndrome due to vancomycin

目的:探讨万古霉素致药物超敏反应综合征(DIHS)的特点,为临床安全用药提供参考。方法:检索中国知网、维普、万方、PubMed、Elsevier、EBSCO数据库中有关万古霉素引起DIHS的文献报道,对患者的一般资料、不良反应发生时间、临床表现及转归等信息进行统计分析。结果:共纳入文献43篇,涉及52例患者,其中男性35例(67.31%),女性17例(32.69%),DIHS多发生于用药后2周(86.54%)。主要临床表现有发热、皮疹、嗜酸性粒细胞增多及多系统/器官受累等;不良反应累及系统/器官以皮肤及其附件(34.37%)为主。所有患者诊断为DIHS后均停用万古霉素,多数患者预后良好(47例,90.38%)。结论:临床使用万古霉素时应加强监测,随时警惕DIHS的发生。

Objective:To explore the characteristics of drug-induced hypersensitivity syndrome(DIHS)induced by vancomycin and provide references for clinical safe medication.Methods:Literature of DIHS induced by vancomycin were retrieved from databases including CNKI,VIP,Wanfang,PubMed,Elsevier and EBSCO.And data were analyzed statistically in terms of general information,onset time of ADR,clinical manifestation and outcome.Results:A total of 43 literature involving 52 patients were enrolled in this study,among which 35 patients were male(67.31%)and 17 patients were female(32.69%).Most DIHS(86.54%)occurred two weeks after administration.The major clinical manifestations were fever,rash,eosinophilia and multiple systems/organs injury.The main system/organ involved in ADR was skin and its accessories(34.37%).All patients stopped vancomycin after being diagnosed with DIHS and most of them(47 cases,90.38%)improved after withdrawal of vancomycin.Conclusion:During the clinical use of vancomycin,it was recommended to strengthen monitoring and be alert to DIHS at any time.