摘要
目的:了解口服万古霉素治疗艰难梭菌感染致皮肤不良反应情况。方法:检索国内、外数据库,检索时间为数据库建库至2023年7月,收集相关文献,提取相关数据进行描述性统计分析。结果:共纳入患者15例,均提及抗生素应用指征,出现艰难梭菌感染后口服万古霉素,其中男性9例,女性6例。儿童2例,≥65岁患者8例。5例患者有肾损伤,11例患者口服万古霉素用量≥500 mg·d^(–1)。不良反应表现为红人综合征、斑丘疹及线性IgA大疱性皮肤病等。5例患者测定万古霉素血药浓度在0.1~28.7 mg·mL^(–1)。不良反应处理方面14例患者停药处理,12例应用抗组胺药物,在后续治疗艰难梭菌方案方面,1例应用非达霉素,3例应用甲硝唑。13例患者皮疹均有不同程度的好转,2例患者因自身基础疾病死亡。结论:口服万古霉素治疗艰难梭菌感染可能会全身吸收,从而导致皮疹,对于高危人群需引起临床重视。
Objective To explore the treatment of oral vancomycin for skin adverse reaction caused by Clostridium difficile infection.Methods Domestic and foreign databases were searched from the inceptions until July 2023.The relevant literatures were retrieved and the related data extracted for descriptive statistical analysis.Results A total of 15 patients were recruited,including 9 males and 6 females.All of them had an indication of antibiotic use and vancomycin was prescribed for C.difficile infection.In terms of age,there were 2 children and 8 patients were 65 years and above.Five cases developed kidney injury.Oral dose of vancomycin was≥500 mg·d^(-1)(n=11).Skin adverse reactions included red man syndrome,maculopapular rash and linear IgA bullous dermatosis.Blood concentration of vancomycin was(0.1-28.7)mg·mL^(-1)(n=5).In terms of adverse reaction management,drug was discontinued(n=14)and antihistamines offered(n=12).For 4 cases on anti-C.difficile regimen,fedamycin(n=1)and metronidazole(n=3)were prescribed.All of them had varying degrees of improvements and 2 cases died from underlying diseases.Conclusion During the treatment of C.difficile infection,oral vancomycin may be absorbed throughout body and leads to rash.Greater attention should be paid to high-risk groups.
作者
武丹威
李锦
杨媛
毛璐
张威
WU Danwei;LI Jin;YANG Yuan;MAO Lu;ZHANG Wei(Department of Pharmacy,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China)
出处
《中国医院药学杂志》
CAS
北大核心
2024年第8期929-934,共6页
Chinese Journal of Hospital Pharmacy
基金
北京积水潭医院学科新星(编号:KXX201821)。
关键词
万古霉素
艰难梭菌
皮肤不良反应
Vancomycin
Clostridium difficile
skin adverse reaction
