Bigby M, Jick S, Jick H, Arndt K
JAMA. 1986 Dec 26;256(24):3358-63. doi: 10.1001/jama.256.24.3358.
We analyzed the data on 15,438 consecutive medical inpatients monitored by the Boston Collaborative Drug Surveillance Program from June 1975 to June 1982 to determine the rates of allergic cutaneous reactions to drugs introduced since 1975 and to confirm and extend findings from an earlier study of the preceding 22,227 patients. There were 358 reactions occurring in 347 patients, for an overall reaction rate among patients of 2.2%. Each patient received a mean of eight different drugs. Rashes were attributed to 51 drugs, and 75% of the allergic cutaneous reactions were attributed to antibiotics, blood products, and inhaled mucolytics. Amoxicillin (51.4 reactions per 1000 patients exposed), trimethoprim-sulfamethoxazole (33.8/1000), and ampicillin (33.2/1000) had the highest reaction rates. Drug-specific reaction rates ranged from zero to 51.4 per 1000 and were determined for 180 drugs or drug groups. These results provide physicians with quantitative data that will be helpful in clinical decision making when drug-induced exanthems, urticaria, or generalized pruritus occurs.
我们分析了1975年6月至1982年6月期间由波士顿药物监测协作计划连续监测的15438名内科住院患者的数据,以确定自1975年以来引入的药物引起的过敏性皮肤反应发生率,并确认和扩展对之前22227名患者早期研究的结果。347名患者发生了358例反应,患者的总体反应率为2.2%。每位患者平均使用了8种不同的药物。皮疹归因于51种药物,75%的过敏性皮肤反应归因于抗生素、血液制品和吸入性黏液溶解剂。阿莫西林(每1000名暴露患者中有51.4例反应)、甲氧苄啶-磺胺甲恶唑(33.8/1000)和氨苄西林(33.2/1000)的反应率最高。针对180种药物或药物组确定了每1000人的药物特异性反应率,范围从零到51.4。这些结果为医生提供了定量数据,有助于在发生药物性皮疹、荨麻疹或全身性瘙痒时进行临床决策。