临床药师参与1例左氧氟沙星致超敏反应的药学监护及文献分析  

Pharmaceutical care for one case of levofloxacin-induced hypersensitivity reaction by the participation of clinical pharmacists and literature analysis

作　　者：殷欢莉 黄跃洲[1] 罗敏[1] 张臣宇 秦舟[1] 唐文言 于磊[1] YIN Huanli;HUANG Yuezhou;LUO Min;ZHANG Chenyu;QIN Zhou;TANG Wenyan;YU Lei(Dept.of Clinical Pharmacy,West China Hospital of Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院临床药学部,成都610041

出　　处：《中国药房》2023年第22期2805-2809,共5页China Pharmacy

基　　金：四川省干部保健科研课题(No.川干研2021-110)。

摘　　要：目的 分析左氧氟沙星致超敏反应的特点。方法 临床药师参与1例左氧氟沙星致超敏反应患者的治疗过程,同时参考相关标准判断左氧氟沙星与超敏反应的关联性;检索中国知网、维普网、万方数据、PubMed、Embase,收集左氧氟沙星致超敏反应的相关文献并进行分析。结果 临床药师针对患者发热、全身皮疹等症状,建议排查其既往用药史和过敏史,同时判断该超敏反应与左氧氟沙星的关联性为“可能”或“很可能”。临床医师根据临床药师的判断,给予患者对症治疗。该患者经治疗后好转。文献分析结果显示,纳入的31例患者中,男性23例,女性8例,50岁及以上18例;24例患者的潜伏期为用药后4 d及以内;不良反应主要为药物超敏反应综合征、固定性药疹、多形性红斑等;多数患者经停药和对症治疗后均好转。结论 超敏反应为左氧氟沙星较罕见的不良反应,多发生于用药后2.5 h~4 d,以中老年男性患者的发生风险较高。临床使用左氧氟沙星前应详细询问患者的药物过敏史,当其出现无明显诱因发热、皮疹时,应及时停药并对症处理,保证患者用药安全、有效。OBJECTIVE To analyze the characteristics of levofloxacin-induced hypersensitivity reaction.METHODS Clinical pharmacists participated in the treatment for a case of levofloxacin-induced hypersensitivity reaction,and adjudged the relationship of levofloxacin with hypersensitivity reaction according to relative standards.Retrieved from CNKI,VIP,Wanfang database,PubMed and Embase,relevant literature about levofloxacin-induced hypersensitivity reaction was collected and analyzed.RESULTS Clinical pharmacists suggested checking the patient’s previous medication and allergy history based on symptoms such as fever and systemic rash,and determined that the drug hypersensitivity was“likely”or“highly likely”to be associated with levofloxacin.Clinicians provided symptomatic treatment to the patient based on the judgment of clinical pharmacists,and the patient improved after treatment.Results of the literature analysis showed that among 31 involved patients,there were 23 males and 8 females;18 patients aged 50 and above;the incubation period of 24 patients was within 4 days after medication.The main adverse drug reactions were drug hypersensitivity syndrome,fixed drug eruption,erythema multiforme,etc.Most patients were improved after withdrawal and symptomatic treatment.CONCLUSIONS Hypersensitivity reaction is the rare adverse drug reaction of levofloxacin,mostly occurring within 2.5 h to 4 days after administration,and it is more likely to occur in middle-aged and elderly patients.Before clinical use,patients should be asked about their drug allergy history in detail;when patients experience fever or rash without obvious causes,medication should be stopped promptly and symptomatic treatment should be taken to ensure the safety and effectiveness of the patients’medication.

关 键 词：左氧氟沙星 超敏反应 药学监护 文献分析 

分 类 号：R969.3[医药卫生—药理学]