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      단일기관 소아청소년 입원 환자에서의 항생제 피부시험 현황 분석 = Current practice of antibiotics skin test in pediatric inpatients: A single-center experience

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      https://www.riss.kr/link?id=A108566110

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      다국어 초록 (Multilingual Abstract)

      Background: Routine practice of antibiotic skin test (AST) before administering antibiotics is with little scientific basis. However, AST is frequently performed in real-world practice. We aimed to explore the current practice status of AST.
      Methods: All admission cases in Severance Hospital between January 2019 and December 2020 of patients at less than 19 years of age were collected retrospectively. AST results for 4 penicillins (ampicillin, ampicillin-sulbactam, amoxicillin-clavulanate, and piperacillin-tazobactam) and 6 cephalosporins (cefazolin, cefotaxime, cefotiam, cefpiramide, ceftriaxone, and flomoxef) as well as adverse drug reaction (ADR) reports were collected.
      Results: Among 36,381 hospitalization cases, 7,589 and 16,468 were administered penicillins and cephalosporins, respectively. Penicillins were administered without AST in 2,622 cases (35%), 2 (0.08%) of which showed ADR. Of the remaining 4,967 cases who received AST, 57 (1.1%) showed a positive reaction. For cephalosporins, 15,473 cases (94%) received antibiotics without AST. Among them, 17 cases (0.1%) showed ADRs. For 995 cases that rceived AST, 22 (2.2%) revealed a positive reaction. Among 79 cases who were AST positive, 10 took the original medication.
      Conclusion: The current practice of AST reveals heterogeneous and inconsistent patterns. This brings the need for a standardized guideline for the safe and effective use of antibiotics.
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      Background: Routine practice of antibiotic skin test (AST) before administering antibiotics is with little scientific basis. However, AST is frequently performed in real-world practice. We aimed to explore the current practice status of AST. Methods: ...

      Background: Routine practice of antibiotic skin test (AST) before administering antibiotics is with little scientific basis. However, AST is frequently performed in real-world practice. We aimed to explore the current practice status of AST.
      Methods: All admission cases in Severance Hospital between January 2019 and December 2020 of patients at less than 19 years of age were collected retrospectively. AST results for 4 penicillins (ampicillin, ampicillin-sulbactam, amoxicillin-clavulanate, and piperacillin-tazobactam) and 6 cephalosporins (cefazolin, cefotaxime, cefotiam, cefpiramide, ceftriaxone, and flomoxef) as well as adverse drug reaction (ADR) reports were collected.
      Results: Among 36,381 hospitalization cases, 7,589 and 16,468 were administered penicillins and cephalosporins, respectively. Penicillins were administered without AST in 2,622 cases (35%), 2 (0.08%) of which showed ADR. Of the remaining 4,967 cases who received AST, 57 (1.1%) showed a positive reaction. For cephalosporins, 15,473 cases (94%) received antibiotics without AST. Among them, 17 cases (0.1%) showed ADRs. For 995 cases that rceived AST, 22 (2.2%) revealed a positive reaction. Among 79 cases who were AST positive, 10 took the original medication.
      Conclusion: The current practice of AST reveals heterogeneous and inconsistent patterns. This brings the need for a standardized guideline for the safe and effective use of antibiotics.

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      참고문헌 (Reference)

      1 손성욱 ; 윤영순 ; 김경선 ; 정선영 ; 박근민, "항생제 피부반응시험 양성인 경우 변경 항생제 분석" 대한천식알레르기학회 31 (31): 48-54, 2011

      2 김성렬 ; 김수정 ; 김세훈 ; 박종숙 ; 박혜정 ; 서동인 ; 심다운 ; 양민석 ; 이재현 ; 이화영 ; 정재우 ; 최미라 ; 강혜련, "사용 전 베타락탐 항생제 피부시험의 유용성에 대한 전문가 의견" 대한 소아알레르기 호흡기학회 10 (10): 3-8, 2022

      3 Doña I, "Trends in hypersensitivity drug reactions : more drugs, more response patterns, more heterogeneity" 24 : 143-153, 2014

      4 Romano A, "Towards a more precise diagnosis of hypersensitivity to beta-lactams-an EAACI position paper" 75 : 1300-1315, 2020

      5 Stone CA Jr, "The challenge of de-labeling penicillin allergy" 75 : 273-288, 2020

      6 이소희 ; 박흥우 ; 김세훈 ; 장윤석 ; 김선신 ; 조상헌 ; 민경업 ; 김유영, "The Current Practice of Skin Testing for Antibiotics in Korean Hospitals" 대한내과학회 25 (25): 207-212, 2010

      7 Narayan P, "Skin testing before antibiotic administration-is there a scientific basis?" 67 : 63-65, 2019

      8 Macy E, "Safely diagnosing clinically significant penicillin allergy using only penicilloyl-poly-lysine, penicillin, and oral amoxicillin" 1 : 258-263, 2013

      9 Blumenthal KG, "Risk-based pathway for outpatient penicillin allergy evaluations" 7 : 2411-2414, 2019

      10 Solensky R, "Penicillin allergy evaluation : a prospective, multicenter, open-label evaluation of a comprehensive penicillin skin test kit" 7 : 1876-1885, 2019

      1 손성욱 ; 윤영순 ; 김경선 ; 정선영 ; 박근민, "항생제 피부반응시험 양성인 경우 변경 항생제 분석" 대한천식알레르기학회 31 (31): 48-54, 2011

      2 김성렬 ; 김수정 ; 김세훈 ; 박종숙 ; 박혜정 ; 서동인 ; 심다운 ; 양민석 ; 이재현 ; 이화영 ; 정재우 ; 최미라 ; 강혜련, "사용 전 베타락탐 항생제 피부시험의 유용성에 대한 전문가 의견" 대한 소아알레르기 호흡기학회 10 (10): 3-8, 2022

      3 Doña I, "Trends in hypersensitivity drug reactions : more drugs, more response patterns, more heterogeneity" 24 : 143-153, 2014

      4 Romano A, "Towards a more precise diagnosis of hypersensitivity to beta-lactams-an EAACI position paper" 75 : 1300-1315, 2020

      5 Stone CA Jr, "The challenge of de-labeling penicillin allergy" 75 : 273-288, 2020

      6 이소희 ; 박흥우 ; 김세훈 ; 장윤석 ; 김선신 ; 조상헌 ; 민경업 ; 김유영, "The Current Practice of Skin Testing for Antibiotics in Korean Hospitals" 대한내과학회 25 (25): 207-212, 2010

      7 Narayan P, "Skin testing before antibiotic administration-is there a scientific basis?" 67 : 63-65, 2019

      8 Macy E, "Safely diagnosing clinically significant penicillin allergy using only penicilloyl-poly-lysine, penicillin, and oral amoxicillin" 1 : 258-263, 2013

      9 Blumenthal KG, "Risk-based pathway for outpatient penicillin allergy evaluations" 7 : 2411-2414, 2019

      10 Solensky R, "Penicillin allergy evaluation : a prospective, multicenter, open-label evaluation of a comprehensive penicillin skin test kit" 7 : 1876-1885, 2019

      11 Castells M, "Penicillin allergy" 381 : 2338-2351, 2019

      12 Korean Academy of Asthma, Allergy and Clinical Immunology, "Korean guidelines for skin testing of antibiotics in patients with immediate type hypersensitivity reaction" Korean Academy of Asthma, Allergy and Clinical Immunology

      13 Executive summary of disease management of drug hypersensitivity : a practice parameter, "Joint Task Force on Practice Parameters, the American Academy of Allergy, Asthma and Immunology, the American Academy of Allergy, Asthma and Immunology, and the Joint Council of Allergy, Asthma and Immunology" 83 : 665-700, 1999

      14 Yang MS, "Incidence of cephalosporin-induced anaphylaxis and clinical efficacy of screening intradermal tests with cephalosporins : a large multicenter retrospective cohort study" 73 : 1833-1841, 2018

      15 Brockow K, "General considerations for skin test procedures in the diagnosis of drug hypersensitivity" 57 : 45-51, 2002

      16 Joint Task Force on Practice Parameters, "Drug allergy : an updated practice parameter" 105 : 259-273, 2010

      17 Park Ji Soo ; Suh Dong In, "Drug Allergy in Children: What Should We Know?" 대한소아청소년과학회 63 (63): 203-210, 2020

      18 Torres MJ, "Controversies in drug allergy : beta-lactam hypersensitivity testing" 7 : 40-45, 2019

      19 Li PH, "Beta-lactam allergy in Chinese patients and factors predicting genuine allergy" 12 : 100048-, 2019

      20 Savic L, "BSACI guideline for the set-up of penicillin allergy de-labelling services by non-allergists working in a hospital setting" 52 : 1135-1141, 2022

      21 Sousa-Pinto B, "Accuracy of penicillin allergy diagnostic tests : a systematic review and meta-analysis" 147 : 296-308, 2021

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