■关于住院儿童药物超敏反应(DHR)的特征和管理的数据有限。这项研究旨在确定患病率,临床特征,儿科住院患者的DHR管理。
在2020年8月1日至2021年7月30日期间在安卡拉比尔肯特市医院住院期间因疑似DHR进行儿科过敏咨询的儿童包括在内。患者和反应特征,罪犯毒品,并记录了管理策略。如果可能,出院后进行诊断性试验(皮肤试验或激发试验).
■在14090名住院儿童中,165(72%男性,中位年龄:106个月)接受了192例疑似DHR和246种药物的咨询。皮肤喷发最常见(94.3%)。40例患者出现过敏反应,4例患者出现严重的皮肤药物不良反应(伴嗜酸性粒细胞增多和全身症状的药疹3例,急性全身性发疹性脓疱病1例)。抗生素是主要原因(78.4%,n=193/246)。在48个反应中,60(24%)的罪魁祸首药物可以通过密切随访或脱敏重新给药(n=12)。总的来说,停用了186种怀疑药物,115人被替代药物取代。放电后,38项激发试验(2项阳性)和36项皮肤试验(1项阳性点刺试验,1阳性皮内试验,和1个阳性斑贴试验)进行。
■儿科住院患者中疑似DHR的发生率约为1.1%。皮肤症状是最常见的表现。24%的可疑药物可以在住院期间继续使用。除非有检查禁忌症,否则住院期间患有DHR的患者应进行药物过敏检查。
UNASSIGNED: There are limited data regarding the characteristics and management of drug hypersensitivity reactions (DHR) in hospitalized children. This study aims to determine the prevalence, clinical features, and management of DHRs in pediatric inpatients.
UNASSIGNED: Children who had pediatric allergy consultation for suspected DHR during hospitalization in Ankara Bilkent City Hospital between August 1, 2020, and July 30, 2021, were included. Patient and reaction characteristics, culprit drugs, and management strategies were recorded. When possible, diagnostic tests (skin or provocation tests) were performed after discharge.
UNASSIGNED: Among the 14,090 hospitalized children, 165 (72% male, median age: 106 months) underwent consultation for 192 suspected DHRs with 246 drugs. Cutaneous eruptions were the most common (94.3%). There was anaphylaxis in 40 patients and severe cutaneous adverse drug reaction in 4 patients (drug rash with eosinophilia and systemic symptoms in 3, acute generalized exanthematous pustulosis in 1). Antimicrobials were the leading cause (78.4%, n = 193/246). In 48 reactions, 60 (24%) culprit drugs could be readministered with close follow-up or desensitization (n = 12). In total, 186 suspected drugs were discontinued, and 115 were replaced with alternative drugs. After discharge, 38 provocation tests (2 positives) and 36 skin tests (1 positive prick test, 1 positive intradermal test, and 1 positive patch test) were performed.
UNASSIGNED: The incidence of suspected DHR among pediatric inpatients was approximately 1.1%. Skin symptoms were the most common manifestation. Twenty-four percent of suspected drugs could be continued during hospitalization. Patients with DHR during hospitalization should be evaluated with a drug allergy work-up unless there are contraindications to testing.