Prevalence and Risk Factors of Cutaneous Adverse Antibiotic Reaction among Inpatients in Six Hospitals, Shanghai, China, 2010 - June 2014 公开

Fu, Chao (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/w9505051c?locale=zh
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Abstract

Introduction: Adverse antibiotic reaction (AAR) is any noxious, unintended, and undesired effect of antibiotics that occurs at doses used for prevention, diagnosis, or treatment. Due to the high antibiotic usage, AAR presents a global public health threat, especially in China, where AAR cost USD $0.5 to 2 billion in 2013. Among all types of AARs, cutaneous adverse antibiotic reactions (CAARs) ranked as the most commonly occurring AAR in China. However, there have been few studies examining risk factors for CAARs.

Methods: We analyzed data from the Adverse Drug Reaction Surveillance System (ADRSS) in six hospitals in Shanghai to identify risk factors associated with CAARs. Results: Children aged 0 - 10 years old were the most affected group. Most AARs were administrated intravenously, and the mean latency period for AARs was 1.21 days. Among all AAR-related antibiotics, cephalosporins, quinolones, and macrolides were most common, and skin and subcutaneous tissue disorders were the most common AARs, accounting for 61.7% of all cases. After controlling for age, gender, hospital, and latency time, the antibiotic used, weight of patient, administration route, and past history of AAR were found significantly associated with CAARs. So patients administered penicillins, weighing < 30 kg, administered the antibiotic orally, and who had a previous history of AAR are more likely to develop CAARs than other patients.

Table of Contents

Table of Contents

Background................................................................................................................. 1

Introduction.............................................................................................................. 1

Antibiotics and Adverse Reactions.......................................................................... 1

Risk Factors for AARs................................................................................................ 2

Cutaneous Adverse Antibiotic Reactions................................................................. 3

Methods....................................................................................................................... 4

Study Population...................................................................................................... 4

Variables................................................................................................................... 4

Data Analyses............................................................................................................ 5

Results......................................................................................................................... 5

Adverse Antibiotic Reactions................................................................................... 5

Cutaneous Adverse Antibiotic Reactions (CAARs)................................................... 7

Discussion................................................................................................................... 9

Conclusion................................................................................................................. 9

Limitations.............................................................................................................. 10

Recommendations................................................................................................. 11

Reference.................................................................................................................. 12

Table 1. Demographic Characteristics of Patients with Adverse Antibiotic Reactions in Six Hospitals, Shanghai, China, 2010 - June 2014..................................................................................................................................... 15

Table 2. Clinical Characteristics of Patients with Adverse Antibiotic Reactions in Six Hospitals, Shanghai, China, 2010 - June 2014 16

Table 3. Antibiotics Administered to Patients with Adverse Antibiotic Reactions in Six Hospitals, Shanghai, China, 2010 - June 2014..................................................................................................................................... 17

Table 4. Classification of Adverse Antibiotic Reactions among Patients in Six Hospitals, Shanghai, China, 2010 - June 2014 18

Table 5. Risk Factors for Cutaneous Adverse Reaction among Patients with Adverse Antibiotics Reactions in Six Hospitals in Shanghai, China, 2010 - June 2014....................................................................................... 19

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