摘要
目的:探讨多黏菌素B(PMB)所致药品不良反应(ADR)的发生情况和临床特征,为临床合理用药提供参考.方法:计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Web of Science、Scopus、the Cochrane Library和Embase数据库中临床注射应用PMB治疗后发生ADR的病例报告或病例系列,检索时限为建库至2023年10月31日.利用澳大利亚乔安娜布里格斯研究所(JBI)循证卫生保健中心的质量评价工具对纳入文献进行评价.采用百分比、汇总表等方式统计结果并进行描述性分析.结果:共纳入37篇注射应用PMB治疗后发生ADR的相关文献,包括51例患者,其中男性患者35例(占68.63％),女性患者16例(占31.37％),年龄为14～86岁.PMB引起的ADR有皮肤色素沉着/过敏(28例)、神经毒性(18例)、肾功能损害(5例)、横纹肌溶解(1例);ADR的发生时间为开始给药后5 min至用药30 d后,12例(占23.53％)患者首次用药后即发生ADR;32例(占62.75％)患者经停药或对症处理后症状有所改善或恢复.结论:临床需加强对PMB导致ADR的认识和监测,及时诊断与治疗,确保临床用药安全.
Abstract
OBJECTIVE:To probe into the incidence and clinical characteristics of adverse drug reactions(ADR)induced by polymyxin B(PMB),so as to provide reference for rational medication in clinic.METHODS:CNKI,Wanfang Data,VIP,CBM,PubMed,Web of Science,Scopus,the Cochrane Library and Embase databases were retrieved to identify case reports or case series related to ADR induced by clinical injection of PMB.The retrieval time was from the establishment of the database to Oct.31st,2023.The literature were assessed by using the quality assessment tool provided by the Joanna Briggs Institute(JBI)Centre for Evidence-Based Health Care.Various methods including percentage calculations,summary tables,and other analytical techniques were employed to quantify the results and conduct descriptive analysis.RESULTS:A total of 37 articles of ADR induced by PMB were enrolled,including 51 patients,with 35 males(68.63％)and 16 females(31.37％),ranging in age from 14 to 86 years.ADR induced by PMB included skin pigmentation/allergy(n=28),neurotoxicity(n=18),renal impairment(n=5),and rhabdomyolysis(n=1).The occurrence time of ADR ranged from 5 minutes to 30 d after the initiation of drug administration.ADR occurred immediately after the first drug administration in 12 cases(23.53％),while symptoms were improved or recovered in 32 cases(62.75％)after drug discontinuation or symptomatic treatment.CONCLUSIONS:Clinical awareness and monitoring of ADR induced by PMB need to be strengthened,with timely diagnosis and treatment to ensure the safety of clinical medication.
基金项目
国家卫生健康委医院管理研究所医院药学高质量发展研究项目(NIHAYS2329)
维普
万方数据