OBJECTIVE:To i nvestigate the clini cal ch aracteristics of
anaphylactic shock induced by
piperacillin and its compound preparation ,and to provide reference for prevention and
treatment of the severe ADR.
METHODS :A case of
anaphylactic shock induced by
piperacillin and
sulbactam were analyzed in our
hospital ,meanwhile ADR
literatures about
piperacillin alone and its compound preparation-induced
anaphylactic shock were collected from
Medline ,CNKI,Wanfang database and VIP during the inception to Jul. 2020.
Gender and age of
patients ,allergic
history ,primary
disease and
treatment ,
skin test ,
administration route and
dosage of
piperacillin and its compound preparation ,occurrence
time and main manifestations of
anaphylactic shock ,
treatment measure and
prognosis were analyzed ,then prevention and
treatment suggestions were put forward. RESULTS:The
patient in this case was transferred to the ICU after partial
hepatectomy. The use of
piperacillin and
sulbactam to prevent postoperative
infection caused
anaphylactic shock. A total of 28
literatures about
anaphylactic shock induced by
piperacillin and its compound preparations were collected from the database (involving 28
patients). Among totally 29
patients,there were 12
male and 17
female;the majority of
patients were 50-59 years old (6 cases,20.69%). Three
patients had allergic
history (
food,
latex gloves ,etc.),and most of the primary
diseases were
infectious diseases or the
drug used in
perioperative period.
Skin tests were carried out in 22
patients(75.86%)before medication and the results were negative. The possible allergenic
drugs of 27 cases which were administered by intravenous route included
piperacillin ,
piperacillin sulbactam and
piperacillin tazobactam. The
dosage was different according to the primary
disease and severity. 14
patients(55.56%)developed
anaphylactic shock within 5 minutes after
drug exposure. The main symptoms were systemic
allergic reaction ,mainly involving the
circulatory system. Except for two
death cases ,the other
patients ’symptoms were relieved
after treatment. CONCLUSIONS :Allergic
history and
skin test results may have limitation in predicting
anaphylactic shock induced by
piperacillin and its compound preparation. Close
monitoring needs to be taken in
patients during these medications. Rescue
therapy should be prepared in advance and countermeasures need to be carried out promptly in case of
anaphylactic shock.