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基于知识的临床决策支持系统在检测抗生素过敏中的应用

The Application of Knowledge-Based Clinical Decision Support Systems to Detect Antibiotic Allergy.

作者信息

Han Nayoung, Oh Ock Hee, Oh John, Kim Yoomi, Lee Younghee, Cha Won Chul, Yu Yun Mi

机构信息

Jeju Research Institute of Pharmaceutical Sciences, College of Pharmacy, Jeju National University, Jeju 63243, Republic of Korea.

FirstDIS Ltd., Seoul 07343, Republic of Korea.

出版信息

Antibiotics (Basel). 2024 Mar 7;13(3):244. doi: 10.3390/antibiotics13030244.

DOI:10.3390/antibiotics13030244
PMID:38534679
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10967561/
Abstract

Prevention of drug allergies is important for patient safety. The objective of this study was to evaluate the outcomes of antibiotic allergy-checking clinical decision support system (CDSS), K-CDS. A retrospective chart review study was performed in 29 hospitals and antibiotic allergy alerts data were collected from May to August 2022. A total of 15,535 allergy alert cases from 1586 patients were reviewed. The most frequently prescribed antibiotics were cephalosporins (48.5%), and there were more alerts of potential cross-reactivity between beta-lactam antibiotics than between antibiotics with the same ingredients or of the same class. Regarding allergy symptoms, dermatological disorders were the most common (38.8%), followed by gastrointestinal disorders (28.4%). The 714 cases (4.5%) of immune system disorders included 222 cases of anaphylaxis and 61 cases of severe cutaneous adverse reactions. Alerts for severe symptoms were reported in 6.4% of all cases. This study confirmed that K-CDS can effectively detect antibiotic allergies and prevent the prescription of potentially allergy-causing antibiotics among patients with a history of antibiotic allergies. If K-CDS is expanded to medical institutions nationwide in the future, it can prevent an increase in allergy recurrence related to drug prescriptions through cloud-based allergy detection CDSSs.

摘要

预防药物过敏对患者安全至关重要。本研究的目的是评估抗生素过敏检查临床决策支持系统(CDSS)K-CDS的效果。在29家医院进行了一项回顾性病历审查研究,并于2022年5月至8月收集了抗生素过敏警报数据。共审查了1586例患者的15535例过敏警报病例。最常开具的抗生素是头孢菌素(48.5%),β-内酰胺类抗生素之间潜在交叉反应的警报比具有相同成分或同类抗生素之间更多。关于过敏症状,皮肤疾病最为常见(38.8%),其次是胃肠道疾病(28.4%)。714例(4.5%)免疫系统疾病病例包括222例过敏反应和61例严重皮肤不良反应。所有病例中有6.4%报告了严重症状警报。本研究证实,K-CDS可以有效检测抗生素过敏,并防止在有抗生素过敏史的患者中开具潜在引起过敏的抗生素。如果未来K-CDS在全国范围内的医疗机构中得到推广,它可以通过基于云的过敏检测CDSS预防与药物处方相关的过敏复发增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e10/10967561/5cd8410f10d7/antibiotics-13-00244-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e10/10967561/9175fcfb7aad/antibiotics-13-00244-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e10/10967561/5cd8410f10d7/antibiotics-13-00244-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e10/10967561/9175fcfb7aad/antibiotics-13-00244-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e10/10967561/5cd8410f10d7/antibiotics-13-00244-g002.jpg

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Incidence and Economic Burden of Adverse Drug Reactions in Hospitalization: A Prospective Study in Korea.住院患者药物不良反应的发生率和经济负担:韩国的一项前瞻性研究。
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Impact of penicillin allergy records on antibiotic costs and length of hospital stay: a single-centre observational retrospective cohort.青霉素过敏记录对抗生素费用和住院时间的影响:单中心观察性回顾性队列研究。
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