β内酰胺类抗生素过敏去标签措施及其效果的范围综述  

Steps and outcome ofβ-lactam antibiotic allergy delabeling:a scoping review

作　　者：周心怡 胡琳 傅孟元 海沙尔江·吾守尔[1] 史录文[1,2] 管晓东[1,2] ZHOU Xinyi;HU Lin;FU Mengyuan;Haishaerjiang·Wushouer;SHI Luwen;GUAN Xiaodong(Department of Pharmacy Administration and Clinical School of Pharmaceutical Sciences,Peking University,Beijing 100191,China;International Research Center for Medicinal Administration,Peking University,Beijing 100191,China)

机构地区：[1]北京大学药学院药事管理与临床药学系,北京100191 [2]北京大学医药管理国际研究中心,北京100191

出　　处：《中华临床免疫和变态反应杂志》2024年第6期519-528,共10页Chinese Journal of Allergy & Clinical Immunology

基　　金：国家自然科学基金(72304011)。

摘　　要：目的对β内酰胺类抗生素过敏去标签措施及其效果研究进行范围综述。方法检索PubMed、中国知网和万方数据库,检索时限为2013年1月1日至2023年9月1日,对国内外抗生素过敏去标签相关研究进行分析,梳理去标签的常见方法及其效果。结果共纳入56项符合入选标准的研究,55.4%发表于2021年及以后,98.2%开展于高收入国家,82.1%关注去除青霉素过敏标签,83.9%为病例系列。所有研究均先进行病史评估,41.1%的研究仅通过药物激发试验对风险最低人群去标签;60.7%研究有医生参与,53.6%有药师参与,44.6%有护士参与。对于抗生素过敏去标签的有效性和安全性,78.6%的研究成功率在85%及以上;41(73.2%)项研究报告了不良反应,但未发生严重不良反应。结论β内酰胺类抗生素过敏去标签可在成人及儿童中安全有效地开展,中国应尽快制订相关指南或规范,推动抗生素过敏去标签试点,促进抗生素规范管理。Objective To compose a scoping review ofβ-lactam antibiotic allergy delabeling steps and their outcomes.Methods Literatures related to study on antibiotic allergy delabeling were searched in PubMed,CNKI and WanFang Data databases since January 1st,2013 to September 1st,2023.Results A total of 56 studies were included,of which 55.4%were published in 2021 or later.98.2%of them were conducted in high-income countries,82.1%focused on penicillin allergy delabeling and 83.9%were case series studies.Medical history assessment was conducted first in all studies,whereas decision of delabeling was made basing on the results of drug provocation test in low-risk population among 41.1%of these studies only.Doctors involved in 60.7%of the studies,while pharmacists and nurses involved in 53.6%and 44.6%of the studies respectively.78.6%of the studies had achieved success rate as higher as not less than 85%for efficacy and safety of antibiotic allergy delabeling.Adverse reactions were reported among 41(73.2%)studies,but no serious adverse reaction was reported.Conclusion Antibiotic allergy delabeling can be carried out safely and effectively in adults and children and related guideline or standard should be developed immediately to promote pilot of antibiotic allergy delabeling and antibiotic administration.

关 键 词：抗菌药物管理 药物过敏 去标签 范围综述 

分 类 号：R47[医药卫生—护理学]