Jones T Aaron, Como Jackson A
Department of Pharmacy, University of Alabama Hospital, Birmingham, Alabama, USA.
Pharmacotherapy. 2003 Jul;23(7):855-60. doi: 10.1592/phco.23.7.855.32729.
To determine the reporting accuracy of true patient-related allergies to drugs in a large teaching institution (908 licensed beds), and to identify factors contributing to medication errors that involved drug allergies. Of particular interest was the accuracy of allergy information in the medical record and the occurrence of medication errors that involved penicillin antibiotics.
From a sample population of 340 patients, 50 adult patients admitted to our university-affiliated hospital who met criteria and had an allergy to selected drugs that was documented in the hospitalwide computer system were randomly selected and interviewed to determine the timing, nature, and extent of the reaction. Furthermore, data were collected from identified Medication Error Reports when an agent was prescribed for a patient with a reported allergy to that agent or class. Prospective data collection was conducted from November 2000-February 2001. Using the information obtained by the patient interview and chart documentation, we assessed the reported allergy. In addition, contributing factors for medication errors that involved drug allergies were identified.
Of the sample population, 133 patients (39%) reported allergies to at least one drug. Allergies to beta-lactams, sulfonamides, and opioid narcotics were reported in 12.6% (43 patients), 9.1% (31), and 14.4% (49) of the sample population, respectively. Most agents involved in medication errors were beta-lactam antibiotics, with an overwhelming number of these errors due to piperacillin-tazobactam (51.4%, 36 errors). Other drugs involved were ampicillin (10%, 7 errors), other beta-lactams (24.3%, 17 errors), opioid narcotics (10%, 7 errors), and sulfonamides (4.3%, 3 errors). Most contributing factors were classified as "MD [prescribing physician] not aware of allergy."
These results suggest a need for ensuring that prescribers review each patient's allergy profile before order entry.
确定一家大型教学机构（拥有908张许可床位）中与患者实际相关的药物过敏报告的准确性，并识别导致涉及药物过敏的用药错误的因素。特别关注的是病历中过敏信息的准确性以及涉及青霉素类抗生素的用药错误的发生情况。
从340名患者的样本群体中，随机选择50名入住我校附属医院且符合标准并在全院计算机系统中有对特定药物过敏记录的成年患者进行访谈，以确定反应的时间、性质和程度。此外，当为报告对某药物或某类药物过敏的患者开具该药物时，从已识别的用药错误报告中收集数据。于2000年11月至2001年2月进行前瞻性数据收集。利用患者访谈和病历记录获得的信息，我们评估了报告的过敏情况。此外，还识别了导致涉及药物过敏的用药错误的相关因素。
在样本群体中，133名患者（39%）报告对至少一种药物过敏。样本群体中分别有12.6%（43名患者）、9.1%（31名）和14.4%（49名）报告对β-内酰胺类、磺胺类和阿片类麻醉药品过敏。涉及用药错误的大多数药物是β-内酰胺类抗生素，其中绝大多数错误是由哌拉西林-他唑巴坦引起的（51.4%，36例错误）。其他涉及的药物有氨苄西林（10%，7例错误）、其他β-内酰胺类（24.3%，17例错误）、阿片类麻醉药品（10%，7例错误）和磺胺类（4.3%，3例错误）。大多数促成因素被归类为“医生[开处方的医生]不知道过敏情况”。
这些结果表明需要确保开处方者在录入医嘱前查看每位患者的过敏情况。
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