Procena preosetljivisti na penicilin: Iskustva Klinike za alergologiju i imunologiju Kliničkog centra Srbije
Sažetak
Uvod: Beta (ß)-laktamski antibiotici su među najčešće propisivanim lekovima širom sveta. Incidencija samostalno prijavljenih slučajeva alergije na penicilin se kreće od 1 do 10%. Pacijenti sa registrovanom alergijom na ß-laktamske antibiotike tretiraju se lekovima drugog izbora, koji su uglavnom toksičniji i skuplji.
Cilj: Cilj ovog istraživanja je da se odredi prevalencija alergije na penicilin, kao i povezanost kliničkih, laboratorijskih i iz korišćene medicinske dokumentacije dostupnih socio-demografskih karakteristika pacijenata sa i bez preosetljivosti na peniciline.
Materijal i metode: Retrospektivna deskriptivna studija je obuhvatila konsekutivne pacijente koji su u periodu 2010-2015. godine lečeni na Klinici za alergologiju i imunologiju Kliničkog centra Srbije (KCS). Korišćeni su anamnestički podaci pacijenata o prijavljenoj alergijskoj reakciji na peniciline i ostale ß-laktamske antibiotike, kao i rezultati in vivo i in vitro testiranja.
Rezultati: U ispitivanje je uključen 81 pacijent, 59 (72.8%) pacijenata ženskog pola. Prosečno životno doba testiranih pacijenata je bilo 41.71±16.47 godina. Neželjene reakcije na penicilinske preparate ukupno je prijavilo 70/81 (86.4%) testiranih pacijenata. Kao najčešći simptomi zabeleženi su ospa (raš, egzantem) i angioedem, što je u skladu sa podacima iz literature. Nijedan od 70 pacijenata sa pozitivnom anamnezom nije imao pozitivne rezultate in vitro testova. Ukupan broj pozitivnih pacijenata nakon in vivo testiranja na penicilin je 2/81 (2.5%).
Zaključak:. Poznato je da oko 90% pacijenata sa podatkom iz istorije bolesti o alergiji na penicilin i druge β-laktamske antibiotike zapravo nisu alergični, pa mogu bezbedno primati ovu grupu lekova u terapijske svrhe, što je potvrđeno i ovom studijom. Ranije studije su pokazale da je preosetljivost na cefalosporine češća kod pacijenata kojima je potvrđena alergija na peniciline. Zbog malog broja pacijenata u našem istraživanju egzaktna procena ukrštene reaktivnosti između penicilina i cefalosporina nije moguća.Reference
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