| 摘要: |
| 目的:了解国内医院β-内酰胺类抗菌药物的皮试现状,为推进该类药物皮试规范管理提供参考。方法:采用问卷调查和访谈相结合的方式,对国内34家妇女儿童专科医院及21家综合性医院的医护人员、药师和药学部门负责人进行调查,并对数据进行统计和分析。结果:共发放调查问卷55份,回收有效问卷55份,有效回收率为100%;对10家医院的问卷填报人访谈完成良好。各家医院β-内酰胺类抗菌药物皮试比例为19%~100%,平均75%。所有医院均对青霉素类注射剂进行皮试。8家医院对口服青霉素类药品未进行皮试。54家医院(剔除仅有1种抗菌药物品种的1家医院)中,进行头孢菌素类注射液皮试的医院有50家,比例为93%。4家医院对口服头孢菌素类进行皮试,10家医院对碳青霉烯类进行皮试,3家医院对单环β-内酰胺类进行皮试。皮试液种类、皮试液剂量及浓度不一。皮试方法均为皮内注射。26家医院有β-内酰胺类抗菌药物皮试文件统一规定,28家医院无相应规定,1家医院仅对青霉素类皮试有规定。11家医院提供了可查询的近3年β-内酰胺类抗菌药物皮试次数共2 727 714例次,平均每家医院每年82 658例次。23家医院提供了近3年β-内酰胺类抗菌药物输液反应例次共6 187例次,每家医院平均每年约90例次。6家医院提供了按药品化学结构分类统计的数据,总计头孢菌素类皮试次数超过了108万例次,达到了青霉素类皮试次数的2倍多,头孢菌素类皮试消耗大量的人力物力并造成环境污染。结论:目前国内β-内酰胺类抗菌药物皮试执行情况差异较大,尤其是有争议的头孢菌素类药物皮试,有待进行统一规范,以促进抗菌药物合理使用和结构合理化。 |
| 关键词: β-内酰胺类抗菌药物 皮试 现状调查 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2018.11.010 |
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| 基金项目: |
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| Investigation on Skin Test for β-lactam Antibiotics in China |
| Zhao Xin1 , Zhang Haixia1 , Cheng Qing2 , Wang Xiaochuan2 , Xiao Juan1 , Wang Xiaoling2 |
| (1.Hunan Children's Hospital, Hunan Changsha 410007, China; 2.Children's National Medical Center, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing 100045, China) |
| Abstract: |
| Objective: To investigate the status of skin test for β-lactam antibiotics in China, so as to provide references for promoting the standard management. Methods: With the combination of questionnaires and interviews, the survey was conducted on medical staff, pharmacists and pharmacy department heads from 34 specialist hospitals for women and children and 21 general hospitals, and then the data were statistically analyzed. Results: A total of 55 questionnaires were distributed and 55 valid questionnaires were returned, with the effective recovery rate of 100%; interviews on questionnaire informants from 10 hospitals were completed well. The proportions of skin test for β-lactam antibiotics in the investigated hospitals were 19%~100%, with an average of 75%. All hospitals performed skin tests on penicillin injections. Eight hospitals did not conduct skin tests on oral penicillins. There were 50 hospitals carried out skin tests on cephalosporin injection, with a ratio of 93%. Four hospitals conducted skin tests on oral cephalosporins, 10 hospitals conducted skin tests on carbapenems and 3 hospitals performed skin tests on monocyclic β-lactams. The types, dosages and concentrations of skin test solution were different. All skin tests were conducted by intradermal injections. Twenty-six hospitals had uniform provisions for skin tests on β-lactam antibiotics with documents, 28 hospitals had no corresponding provisions, and 1 hospital only had provisions of skin test for penicillin. Eleven hospitals provided a total of 2,727,714 skin testes for β-lactam antibiotics in recent 3 years for inquiry, with an average of 82,658 cases per year in each hospital. Totally 23 hospitals provided 6 187 infusion cases of β-lactam antibiotics in recent 3 years, with an average of 90 cases per year. Six hospitals provided statistics classified by chemical structure of drugs; the total number of skin tests for cephalosporin was over 1. 08 million, which was more than twice the number of penicillin. The skin tests for cephalosporin consumed a lot of manpower and material resources, which had caused environmental pollution. Conclusion: At present, the implementation of skin tests for β-lactam antibiotics is in a quite difference, especially the controversial skin tests for cephalosporin, which needs to be standardized to promote the rational application of antibiotics. |
| Key words: β-lactam antibiotics skin test investigation on current status |
