Antonen J A, Markula K P, Pertovaara M I, Pasternack A I
Department of Medicine, Tampere University Hospital, Medical School, University of Tampere, Finland.
Scand J Rheumatol. 1999;28(3):157-9. doi: 10.1080/03009749950154220.
Trimethoprim-associated systemic reactions, including aseptic meningitis, have been reported to be very rare adverse drug reactions. Patients with Sjögren's syndrome have been overrepresented, but no epidemiological surveys of the reaction have been conducted. To study the overall frequency of adverse drug reactions, and especially trimethoprim-associated reactions, we interviewed 85 primary Sjögren's syndrome patients and compared the results with those of 45 similarly interviewed osteoarthritis patients. Antimicrobial allergy was more common among Sjögren's syndrome patients than in osteoarthritis patients (46% vs. 27%). Eleven Sjögren's syndrome patients (13%), but no osteoarthritis patient, had experienced at least a partial, non-allergic systemic reaction with trimethoprim. Of them five (6%) had had a full-blown systemic reaction including both chills/fever and headache/backache and at least one of the following: malaise, vomiting, dizziness, confusion or meningeal irritation. Our findings confirm that allergic reactions to antimicrobials are frequent in Sjögren's syndrome. In addition to allergic reactions Sjögren's syndrome patients are prone to a specific trimethoprim-associated systemic reaction. This should be remembered when prescribing antimicrobials.
据报道，包括无菌性脑膜炎在内的甲氧苄啶相关全身反应是非常罕见的药物不良反应。干燥综合征患者在这类反应中所占比例过高，但尚未对该反应进行流行病学调查。为了研究药物不良反应的总体发生率，尤其是甲氧苄啶相关反应的发生率，我们对85例原发性干燥综合征患者进行了访谈，并将结果与45例接受类似访谈的骨关节炎患者的结果进行了比较。干燥综合征患者中抗菌药物过敏比骨关节炎患者更常见（46%对27%）。11例（13%）干燥综合征患者至少经历过一次甲氧苄啶引起的部分性、非过敏性全身反应，但骨关节炎患者中无人出现这种情况。其中5例（6%）出现了全面的全身反应，包括寒战/发热和头痛/背痛，以及以下至少一种症状：不适、呕吐、头晕、意识模糊或脑膜刺激征。我们的研究结果证实，干燥综合征患者对抗菌药物的过敏反应很常见。除过敏反应外，干燥综合征患者还容易出现特定的甲氧苄啶相关全身反应。在开具抗菌药物处方时应牢记这一点。
