Sonntag M R, Zoppi M, Fritschy D, Maibach R, Stocker F, Sollberger J, Buchli W, Hess T, Hoigné R
Schweiz Med Wochenschr. 1986 Feb 1;116(5):142-5.
Of 19,653 patients hospitalized in the medical divisions of two teaching hospitals, 3980 were treated with an aminopenicillin, 808 with other penicillins, 427 with a cephalosporin, 2619 with cotrimoxazole and 846 with allopurinol. The first part of the study deals only with the incidence of exanthemas definitely or probably due to a specific drug on the basis of clinical considerations. The exanthema incidence is 8.0% for aminopenicillins, 4.7% for other penicillins, 1.9% for cephalosporins and 2.8% for cotrimoxazole. The second part of the study employs a cross-tabulation to determine the incidence of exanthemas definitely and probably drug-induced, and the temporal relationship of these reactions to aminopenicillin and allopurinol exposure. The observed risks of developing an exanthema are as follows: aminopenicillin without allopurinol 10.1%, aminopenicillin combined with allopurinol 7.2%, allopurinol without aminopenicillin 3.0%, neither of the two drugs 1.5%. The increased incidence of exanthemas observed by the Boston Collaborative Drug Surveillance Program (BCDSP) in patients concomitantly treated with aminopenicillin and allopurinol was not confirmed by our results. Our hypothesis is that the time of exposure to aminopenicillins might have been shorter for patients of the BCDSP who were not treated in connection with neoplastic disease and did not receive allopurinol. The incidence of aminopenicillin induced exanthemas increases severalfold with the duration of exposure time during the first 2-3 weeks. In the CHDMB, on the other hand, exposure time does not differ between the patients treated with aminopenicillin alone or in combination with allopurinol.
在两家教学医院内科住院的19653名患者中，3980人接受了氨基青霉素治疗，808人接受了其他青霉素治疗，427人接受了头孢菌素治疗，2619人接受了复方新诺明治疗，846人接受了别嘌醇治疗。研究的第一部分仅根据临床考虑探讨明确或可能由特定药物引起的皮疹发病率。氨基青霉素引起的皮疹发病率为8.0%，其他青霉素为4.7%，头孢菌素为1.9%，复方新诺明为2.8%。研究的第二部分采用交叉列表法来确定明确和可能由药物引起的皮疹发病率，以及这些反应与氨基青霉素和别嘌醇暴露之间的时间关系。出现皮疹的观察风险如下：未使用别嘌醇的氨基青霉素为10.1%，使用别嘌醇的氨基青霉素为7.2%，未使用氨基青霉素的别嘌醇为3.0%，两种药物均未使用为1.5%。我们的结果未证实波士顿药物监测协作计划（BCDSP）观察到的同时接受氨基青霉素和别嘌醇治疗的患者皮疹发病率增加。我们的假设是，对于未因肿瘤疾病接受治疗且未接受别嘌醇的BCDSP患者，接触氨基青霉素的时间可能较短。在最初的2至3周内，氨基青霉素引起的皮疹发病率随接触时间的延长而增加数倍。另一方面，在冠心病药物监测研究中，单独使用氨基青霉素或与别嘌醇联合使用的患者之间接触时间并无差异。
