贝塔乳酸过敏标签对骨髓移植患者的影响
Benjamin M Haxby1, Kendall J Tucker2, Caitlin M McCracken2
1Department of BioHealth Sciences, College of Science, Oregon State University, Corvallis, OR, USA.
概括
许多被标记为β-乳酸过敏的患者并不是真正的过敏. 在骨髓移植 (BMT) 患者中,这种过敏标签增加了卡巴胺的使用,但并没有增加死亡风险. 对青素过敏的取消标签可能会优化抗生素的使用.
科学领域:
- 传染性疾病 传染性疾病
- 血液学 血液学 血液学
- 临床药理学 临床药理学
背景情况:
- 贝塔乳酸过敏标签很常见,但约95%的患者并不是真正的过敏.
- 不必要的避开β-乳糖胺可以导致治疗失败和抗生素耐药性.
- 骨髓移植 (BMT) 患者可能面临更高的风险,原因是免疫力受损和易受感染.
研究的目的:
- 评估β-乳酸过敏标签对 BMT 患者结果的影响.
- 评估过敏标签与不良临床结果之间的关联.
- 确定过敏标签对抗生素处方模式的影响.
主要方法:
- 成年 BMT 住院患者的回顾性队列研究 (2018 年 4 月至 2020 年 3 月).
- 对青素过敏测试和取消标签的资格评估.
- 多变量后勤回归分析对100天死亡率,ICU入院,再住院和IV抗生素使用的影响.
主要成果:
- 在358名 (21%) 的BMT患者中,有75名患有基线β-乳酸过敏标签.
- 过敏组的死亡率较高 (14.7%与7.8%,P=0.067),但在多变量分析中没有统计学意义 (OR=1.60).
- 过敏标签的患者接受卡巴因的可能性显著增加 (OR=6.27).
结论:
- 贝塔乳过敏标签没有显著增加 BMT 患者的死亡风险.
- 在患有过敏标签的患者中观察到碳烯使用量的显著增加.
- 对青素过敏的取消标签计划显示出优化对 BMT 种群的抗生素处方的承诺.
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