头孢菌素类注射剂皮试的规范化管理及分析.

OBJECTIVE: To analyze the effect and economic value of standardized cephalosporin injection skin test on the rationality of clinical use of antibiotics in Hospital of Chengdu Office of People’ s Government of Tibetan Autonomous Region ( hereinafter referred to as “ the hospital ”), so as to provide reference and basis for the standardized management of skin tests of cephalosporin. METHODS: Data of skin test screening, drug allergy and dressing change before and after standardized skin test for cephalosporin injection were retrospectively analyzed. Meanwhile, the economic study of standardized skin test for cephalosporin injection was carried out from the aspects of drug cost, consumable cost and nursing labor time. RESULTS: Before the standardized cephalosporin injection skin test in the hospital, the rate of skin test was as up to 95. 14%(2 782 / 2 924), the positive rate of skin test was about 2. 19%(61 / 2 782), and the incidence of allergic reaction in patients was 0. 34% ( 10 / 2 924), including 0. 03% (1 / 2 924) incidence of life-threatening severe allergic reactions. After standardizing cephalosporin skin test, the rate of skin test decreased to 15. 84%(384 / 2 424), the positive rate of skin test was 3. 91%(15 / 384), the incidence of allergic reaction decreased to 0. 29%(7 / 2 424), and all patients showed grade Ⅰ or Ⅱ allergic reactions. In terms of economy, after standardizing cephalosporin skin test, the per capita cost of skin test from the perspective of patients decreased by 70. 64% ( from 29. 50 yuan to 8. 66 yuan), and the per capita cost from the perspective of medical institutions decreased by 76. 30%( from 53. 16 yuan to 12. 60 yuan). CONCLUSIONS: Non-standard cephalosporin skin test not only cannot predict allergy, but may increase the risk of abuse of other antibiotics and lead to the neglect of allergic reactions by medical staff, and also bring unnecessary economic burden to patients, medical insurance and the whole society. [ABSTRACT FROM AUTHOR]