在风湿病学中的青素和β-乳糖抗生素过敏:一个范围审查
Michael Weaver1, Madalyn Walsh2, Amir Abidov2
1Freeman Health System, Joplin, MO.
概括
许多患有系统性自身免疫性风湿性疾病 (SARD) 的患者被错误地标记为青素过敏,导致过度使用广谱抗生素. 很少有人确诊过敏,这凸显了在这个人群中需要更好的诊断策略.
科学领域:
- 类风湿病学 类风湿病学
- 临床免疫学临床免疫学
- 传染性疾病 传染性疾病
背景情况:
- 自我报告的β-lactam抗生素过敏很常见,但往往没有得到证实.
- 这种错误的标签导致抗生素耐药性和较差的患者结果.
- 患有系统性自身免疫性风湿性疾病 (SARD) 的患者可能患有这些标签的患病率更高,对他们的过敏状况的了解有限.
研究的目的:
- 描述SARS患者中β-乳酸过敏的患病率,潜在原因,取消标签策略和临床影响.
- 在风湿病学中确定β-乳酸过敏评估的研究缺口.
主要方法:
- 一个由Arksey和O'Malley框架指导的范围审查.
- 在主要数据库 (MEDLINE,CINAHL,Embase,Web of Science,Scopus) 中进行全面的文献搜索.
- 包括报告SARS患者beta-lactam过敏原始数据的研究,遵守PRISMA-ScR指南.
主要成果:
- 20项研究符合来自9447个记录的纳入标准.
- 在SARD患者中,报告的β-乳酸过敏标签范围从4.5%到37%.
- 确认过敏仅在0.5%至4.4%的被评估为脱标的患者中发现;免疫失调和抗生素暴露被认为是导致误标的因素.
结论:
- 在评估类风湿病患者的β-乳酸过敏方面存在显著的差距.
- 针对SARD患者的有效和安全的脱标策略需要进一步调查.
- 改善过敏评估对于优化抗生素使用和SARD患者的患者护理至关重要.
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