摘要:
抗菌药物热是指因药物的化学结构及患者的特异体质,在用药过程中表现出来的个体特异性的发热反应。其发病机制可能与变态反应有关,以Ⅲ型变态反应最多见。临床上主要表现为用药后立即或用药后7～14d出现的无法用当前病症解释的低热至中等热,可伴有皮疹、肝、脾、淋巴结肿大、全身不适等。主要诊断依据是:用药后体温上升;停药后体温复常;无明确的感染证据。处理原则:在排除感染的基础上,停药观察;感染尚未控制者,更换致热可能性较小的抗菌药物,并简化治疗;或合并使用小剂量糖皮质激素。
Abstract:
Antibacterial agents associated fever,a kind of drug fever,means that fever is due to the administration of antibacterial agents,which may be related to the chemical construction of drug and idiosyncrasy.The mechanisms involved in drug fever may be mainly Type Ⅲ immune complex;or a combination of hypersensitivity reaction.Fever may devlop immediately after administration of a drug,or more commonly after one to two weeks of administration,which can not be accounted by present illness.The fever is usually low or middle-grade,may or may not be accompanied with skin rash,hepatosplenomegaly,lymphadenopathy,and malaise.The diagnosis of drug fever depends on:increase of body temperature after administration of a drug;cessation of fever after discontinuing of a drug;and no evdence of infection.The best way of treating drug fever is to discontinue the offending antibacterial agents followed by stringent medical survey in case of sever infection.If infection is not under control,it is recommended to change drug to a less fever-causing antibacterial agents,or in combination with the use of small dosage of steroid.
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