Macy Eric, Poon K-Y T
Department of Allergy, Southern California Permanente Medical Group, San Diego Medical Center, San Diego, Calif 92111, USA.
Am J Med. 2009 Aug;122(8):778.e1-7. doi: 10.1016/j.amjmed.2009.01.034.
Data on the prevalence and incidence of adverse reactions to antibiotics in outpatient populations are rare. These events are commonly called "allergy" when noted in the medical record.
Determine the prevalence and incidence of allergy, as recorded in the medical record, to the most commonly used antibiotic classes in a large outpatient population using health care in the United States during 2007.
Data for drug allergy and antibiotic use were extracted from the electronic health records of 411,543 patients cared for by Kaiser Permanente in San Diego County who had at least one outpatient visit during 2007. Outpatient antibiotic utilization data was obtained for each year between 1995 and 2007. Penicillins, sulfas, cephalosporins, tetracyclines, macrolides, and quinolones were the classes of antibiotics evaluated.
Antibiotics account for a majority of drug allergy entries. Antibiotic classes with higher historical use have higher allergy prevalence. Female patients use more antibiotics than males, and have higher allergy prevalence rates for all classes of antibiotics. There is a steady increase in antibiotic allergy prevalence with aging for both sexes. Females have higher allergy incidence rates for all classes of antibiotics. Antibiotic allergy incidence in female patients is highest for sulfas, 3.4%, compared with 1%-1.5% for all other classes of antibiotics. Antibiotic allergy incidence in males also is highest for sulfas, 2.2%, compared with 1.1% for penicillins and 0.5%-0.6% for all other classes of antibiotics.
Female sex, use, and increasing age are the primary factors that account for higher antibiotic allergy prevalence. Antibiotic allergy incidence is highest with sulfa class antibiotics.
关于门诊患者抗生素不良反应的患病率和发病率的数据很少。这些事件在病历中被记录时通常称为“过敏”。
确定2007年在美国使用医疗保健服务的大量门诊患者病历中记录的对最常用抗生素类别的过敏患病率和发病率。
从2007年至少有一次门诊就诊的圣地亚哥县凯撒医疗集团所护理的411543名患者的电子健康记录中提取药物过敏和抗生素使用数据。获取了1995年至2007年每年的门诊抗生素使用数据。评估的抗生素类别包括青霉素类、磺胺类、头孢菌素类、四环素类、大环内酯类和喹诺酮类。
抗生素占药物过敏记录的大部分。历史使用量较高的抗生素类别过敏患病率较高。女性患者使用的抗生素比男性多，并且所有抗生素类别的过敏患病率都更高。两性的抗生素过敏患病率均随年龄增长而稳步上升。所有抗生素类别的女性过敏发病率都更高。女性患者中磺胺类抗生素的过敏发病率最高，为3.4%，而所有其他抗生素类别的过敏发病率为1% - 1.5%。男性中磺胺类抗生素的过敏发病率也最高，为2.2%，而青霉素类为1.1%，所有其他抗生素类别的过敏发病率为0.5% - 0.6%。
女性、用药情况和年龄增长是导致抗生素过敏患病率较高的主要因素。磺胺类抗生素的过敏发病率最高。
