Bowrey D J, Morris-Stiff G J
East Glamorgan Hospital, Pontypridd, Wales.
Int J Clin Pract. 1998 Jan-Feb;52(1):20-1.
From our clinical practice, it was apparent that patients often reported drug allergies without a substantiating history. A prospective study over six months was undertaken to examine the reporting of drug allergies by hospital patients. Based on the history, allergic reactions were triaged into one of three categories: high probability of an allergic reaction, low probability of an allergic reaction, and uncertain, where the history was incomplete or unclear. Of 1519 patients interviewed, 133 (9%) reported prior drug allergies. The most commonly implicated agents were penicillin (74%), septrin (6%), aspirin (6%), cefuroxime (2%) and trimethoprim (2%); 61% of reactions were deemed to be high probability, with the remainder either low (29%) or uncertain (10%) probability. It was apparent that patients often considered drug allergy to be synonymous with adverse reaction. Preventing patients from being labelled as drug allergic, thus being denied therapy with first-line agents, requires patient education and vigilance by doctors in their history-taking.
从我们的临床实践来看，很明显患者常常在没有确凿病史的情况下报告药物过敏。我们进行了一项为期六个月的前瞻性研究，以调查住院患者对药物过敏的报告情况。根据病史，过敏反应被分为三类：过敏反应可能性高、过敏反应可能性低以及不确定（病史不完整或不清楚）。在接受访谈的1519名患者中，133名（9%）报告有既往药物过敏史。最常涉及的药物是青霉素（74%）、复方新诺明（6%）、阿司匹林（6%）、头孢呋辛（2%）和甲氧苄啶（2%）；61%的反应被认为过敏反应可能性高，其余的要么可能性低（29%），要么不确定（10%）。很明显，患者常常认为药物过敏与不良反应同义。要防止患者被贴上药物过敏的标签，从而被拒绝使用一线药物治疗，需要对患者进行教育，并且医生在问诊时要保持警惕。
