Beta-Lactam Antibiotic Sensitization and Its Relationship to Allergic Diseases in Tertiary Hospital Nurses

다국어 초록 (Multilingual Abstract)

Purpose: Skin allergies through type 1 and 4 hypersensitivity reactions are the most frequent manifestations of drug allergies. We had previously experienced a case of a nurse with cefotiam-induced contact urticaria syndrome. To aid in preventing the progression of drug-induced allergic disease in nurses, we conducted a survey of tertiary hospital nurses who were likely to have been exposed professionally to antibiotics. Methods:All 539 staff nurses at a tertiary hospital were asked to respond to a questionnaire regarding antibiotic exposure. Of the 457 nurses (84.8%) who responded,427 (79.2%) received a physical examination of the hands and 318 (59.0%) received skin prick tests with the b-lactam antibiotics cefotiam,cefoperazone, ceftizoxime, flomoxef, piperacillin and penicillin G. Results: A positive response to at least one of the antibiotics occurred in 8(2.6%) of the 311 subjects included in the analysis and stages 1 and 2 contact urticaria syndrome were observed in 38 (8.9%) and 3 (0.7%) of 427nurses, respectively. The frequencies of a positive antibiotic skin test (6.9 versus 1.3%, c2=7.15, P=0.018), stage 1 contact urticaria syndrome (14.4versus 7.4%, c2=4.33, P=0.038) and drug allergy (15.3 versus 3.6%, c2=18.28, P=0.000) were higher in subjects with a positive skin allergy history than in those without. Allergic rhinitis (P=0.02, OR=3.86, CI=1.23-12.06), night cough (P=0.04, OR=3.12, CI=1.03-9.41) and food allergy (P=0.00,OR=9.90, CI=3.38-29.98) were significant risk factors for drug allergy. Conclusions: Antibiotic sensitization and drug allergy occurred more frequently in nurses with a positive skin allergy history. Atopy may be an important risk factor for drug allergy.

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