摘要
青霉素可引发过敏反应一直以来是重要议题。在普通人群中,自述青霉素过敏的比例高达10%~20%,但研究表明其中经过检查确认为真正过敏的比例只有5%~10%。错误的青霉素过敏诊断会导致医疗费用增加,细菌耐药概率增加。使用正确的诊断方法,排除伪青霉素过敏具有重大而深远的意义。欧美国家指南规定在青霉素肌注或静脉注射前不需要常规行青霉素皮肤试验,而怀疑有青霉素过敏史的患者,会由过敏科医师进行一系列检查,包括皮肤点刺试验,皮内试验,特异性Ig E检测及激发试验进行诊断。然而我国目前规定在使用青霉素类药物前对所有患者常规进行皮肤试验。本文旨在回顾青霉素过敏的药理学基础,介绍国外青霉素过敏的诊断流程和方法,探讨我国目前操作方法可能存在的缺陷。
It is an important issue all the time that penicillin can lead to allergic reactions. Self-reported penicillin al- lergy is very common and account for 10% to 20% of the general population. Recent studies had indicated that only approximately 5% - 10% of these self-reported penicillin allergy patients are truly allergic and most of them could tolerate penicillin safely. Inaccurate label of penicillin allergy can contribute to increased antibiotic resistance and heahhcare costs. Therefore an accurate diagnosis to exclude false penicillin allergy is essential. According to the European and American guidelines, there is no need to do routine skin test before intramuscu- lar or intravenous injection of penicillin for every patient. But for those patients With suspected penicillin allergy history, a series of allergy tests, including skin prick test, intradermal test, specific IgE detection and drug provocation test should be performed by allergists to confirm the diagnosis. However in our country, routine skin test before using penicillin for every patient is a mandatory provision in regulations. The purposes of this paper are to review the pharmacological basis of penicillin allergy, to introduce penicillin allergy diagnostic processes and methods in foreign countries and to discuss the possible flaws in the methods that we used in clinical prac- tice at present.
出处
《中华临床免疫和变态反应杂志》
2016年第4期412-420,共9页
Chinese Journal of Allergy & Clinical Immunology
关键词
青霉素类
药物过敏
penicillin
drug hypersensitivity
