Zehnder D, Künzi U P, Maibach R, Zoppi M, Halter F, Neftel K A, Müller U, Galeazzi R L, Hess T, Hoigné R
Medizinische Klinik, Zieglerspital Bern.
Schweiz Med Wochenschr. 1995 Apr 8;125(14):676-83.
In 3 divisions of internal medicine of teaching hospitals of the Comprehensive Hospital Drug Monitoring (CHDM) Foundation Bern/St Gallen, 42,920 patients consecutively admitted between 1974-1991 were investigated for adverse drug reactions. Of these 16,150 patients (38%) had received at least one systemically administered antibacterial drug during the hospital stay. Antibiotic-associated colitis included the following diagnoses: pseudomembranous colitis, hemorrhagic colitis and milder forms of colitis. We collected the data of these patients by searching for all diagnoses which might represent antibiotic-associated colitis (from the list of WHO adverse drug reaction terminology). 9 individual patients with one episode of probable antibiotic-associated colitis were found. In 5 of these cases, only one drug given during the hospital stay seemed to be implicated. An additional 32 patients were admitted with antibiotic-associated colitis in relation to treatment with the same groups of drugs before hospital admission. Based on the exposure pattern of the 9 patients with antibiotic-associated colitis compared to all patients exposed during hospital stay, we estimated the following frequencies related to the drug groups with at least 1,000 patients exposed: for all antibacterial chemotherapeutics 0.6/1000 (0.25-1.06); all penicillins 0.6/1000 (0.22-1.32), for benzyl-, phenoxy-, ureido-, isoxazolyl penicillins and methicillin 2.0/1000 (0.42-5.92) and aminopenicillin or analogues, with or without clavulanic acid 0.6/1000 (0.18-1.35). For cephalosporins the frequency is 1.4/1000 (0.17-5.12). Under sulfonamides combined with trimethoprim or related substances (5077 exposed patients) and fluoroquinolones (1043 exposed patients) no case was observed.(ABSTRACT TRUNCATED AT 250 WORDS)
在伯尔尼/圣加仑综合医院药物监测(CHDM)基金会教学医院的3个内科科室,对1974年至1991年间连续收治的42920例患者进行了药物不良反应调查。其中16150例患者(38%)在住院期间至少接受过一种全身应用的抗菌药物。抗生素相关性结肠炎包括以下诊断:伪膜性结肠炎、出血性结肠炎和较轻形式的结肠炎。我们通过搜索所有可能代表抗生素相关性结肠炎的诊断(来自世界卫生组织药物不良反应术语列表)来收集这些患者的数据。发现9例个体患者发生过一次可能的抗生素相关性结肠炎。在其中5例中,住院期间给予的仅一种药物似乎与之有关。另外32例患者在入院前因使用相同药物组治疗而发生抗生素相关性结肠炎。根据9例抗生素相关性结肠炎患者与住院期间所有暴露患者的暴露模式,我们估计了与至少1000例暴露患者的药物组相关的以下频率:所有抗菌化疗药物为0.6/1000(0.25 - 1.06);所有青霉素为0.6/1000(0.22 - 1.32),苄基、苯氧基、脲基、异恶唑基青霉素和甲氧西林为2.0/1000(0.42 - 5.92),氨基青霉素或其类似物(含或不含克拉维酸)为0.6/1000(0.18 - 1.35)。头孢菌素的频率为1.4/1000(0.17 - 5.12)。在与甲氧苄啶或相关物质联合使用的磺胺类药物(5077例暴露患者)和氟喹诺酮类药物(1043例暴露患者)中未观察到病例。(摘要截短至250字)