Adverse Drug Reactions Of Common Antibacterial Drugs And Analysis Of Influence Factor

Objective:By investigating the case of adverse antibiotics reaction in published literature,the types,occurrence characteristics and influence factors of antibacterial drug adverse reaction(ADR)were analyzed.Medical staff should acquire the knowledge of antibacterial ADR and ensure the rational use of antibacterial drugs.Methods:The literature about antibiotics-induced ADR from January 2006 to December 2015 retrieved from CNKI.Antibacterial drug name and adverse reactions as a topic and title search term,antibacterial drug trade name as a supplementary search term.The literature of detailed record on drug use and adverse reactions occurred were included.The literature of review,repeat published and cases cannot trace details were ruled out.The report including more than 16 kinds of antibacterial drug were selected.The primary disease,patient information,allergies history,the dosage regiment and the system of ADR were collected by excel with each drug.The irrational drug use of dosage regiment were analyzed,the number of irrational drug use and the percentage were calculated.The occurrence time of ADR,the clinical manifestation and the proportion were summarized.The patients' information,allergies history and the influence of adverse reactions of the dosage regimen were analyzed.The factors of ADR were simultaneously summarized.Result:745 articles meet the requirements after screening,and 868 cases of antibacterial drug adverse reaction were reported.Among 868 cases of antibacterial drug adverse reaction report,there was no obvious difference in the sex ratio,the male and female ratio 1.06:1.The incidence of ADR was mainly 29.72%of the old over 60 years,followed by 27.65%of the people among 25 years old to 45 years old.24 kinds of antibiotics were involved in ADR,Cefodizime sodium the least,while moxifloxacin the top.Among the 868 cases of ADR,which manifested chiefly as allergic reaction(52.76%),the nervous system toxicity(18.57%)and renal toxicity(7.37%).Beta-lactam antibiotic had the higher incidence of allergic reaction than quinolones and nitroimidazoles.Imipenem cilastatin had the higher incidence of nerve system toxicity than moxifloxacin.The number of nerve system toxicity increases with the growth of medication time.Anaphylactic shock was main clinical symptoms of severe adverse reactions(69.38%).Penicillin has the highest incidence of anaphylactic shock(42.5%).ADR was manily occurred in respiratory system,accounting for 50%,a total of 434 cases.Most of administration route was intravenous drip in 80.76%,followed by oral medication(14.75%).The duration of ADR with less than one hour manily accounted for 43.66%,after that dropped sharply,with exceed three days rising dramatically.The occurrence probability of allergy is 64.58%when the patients with allergy history use the drug again.Twenty five patients had a history of medication,but had no history of adverse reactions(2.88%).The occurrence probability allergic reaction of oral preparations is more but the number of skin test is little.The rate of cephalosporin skin allergy test is low,accounting for 31.53%and the false negative rate of skin test is high,accounting for 84.38%.The false negative rate of meta-pragmatic drug skin test was 81.19%,and false negative rate of alternative medicine skin test was 88.57%.There was only one case having skin anaphylactic test for the oral penicillin.The highest percentage of irrational medication is cefotiam.The most common irrational medication is high dosage,the second is dose normal but dosing low frequency,resulting in a larger single dose.Conclusion:Allergic reaction is the most common and serious adverse reactions.Anaphylactic shock was main clinical symptoms of severe adverse reactions.Various factors may lead to the occurrence of ADR,including the patient's age,the dosage,the drug delivery time,delivery times,delivery way,allergies history,skin test and improper combination and so on.Therefore,we should strengthen the antibacterial drug classification management,strictly mastering the medication indications can reduce or avoid the occurrence of ADR.