Turkiye Klinikleri Journal of Pediatrics

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Penisilin Allerjisi ve Testi
Penicillin Allergy and Penicillin Allergy Test: Review
Şenay ÇETİNKAYAa, Tülay TENGİRb
aÇukurova Üniversitesi Adana Sağlık Yüksekokulu Çocuk Sağlığı ve Hastalıkları Hemşireliği, ADANA
bSelçuk Üniversitesi Sağlık Bilimleri Enstitüsü Çocuk Sağlığı ve Hastalıkları Hemşireliği, KONYA
Turkiye Klinikleri J Pediatr. 2008;17(3):175-82
Article Language: TR
Full Text
ÖZET
Dünya Sağlık Örgütü' nün tanımlamasına göre "tanı, tedavi veya koruma amacı ile uygun dozda verilen bir ilacın, hastada istenmeyen ve beklenmeyen zararlı bir yanıt oluşturmasına "ilaç reaksiyonu" denmektedir. İlaç reaksiyonları immün ve immün olmayan mekanizmalarla gelişir. Oluşumunda immün mekanizmaların yer aldığı bir grup ilaç reaksiyonu "ilaç allerjisi" olarak tanımlanır. Allerjik ilaç reaksiyonları, en yaygın form olan deri reaksiyonu ile birlikte, ilaç yan etkilerinin %5-10' unu oluşturur. Hastane masraflarının ilaç reaksiyonları nedeniyle, birim yatak için yılda 7000 olduğu ve morbidite ile mortalite maliyetinin sadece ABD' de yılda 136 milyon dolardan fazla olduğu tahmin edilmektedir. Penisilin 1928' de Fleming tarafından bulunmuştur. Penisilinler, en sık reçete edilen ve Birleşmiş Milletler' de ilaç allerjilerinin en yaygın nedenleri olan antibiyotiklerdir. Penisilin deri testi, 1960' larda immunolojik belirleyicilerin açıklanmasından sonra gelişmiş ve penisilin allerjisi, spesifik IgE antikor varlığı ya da yokluğunun tespitinde en kesin metot olarak kalmıştır. Penisilin allerjisi oranı %1-10 olmakla beraber yaşamı tehdit edici anafilaksi oranı %0,02 ile %0,05 olarak tahmin edilmektedir. Çocukluk yaş grubunda ilaç reaksiyonları öyküsü olan ve penisilin uygulanması gereken hastalara veya penisilin allerjisi öyküsü şüpheli olan ve antibiyotik tedavisi planlanması arifesinde olan hastalara penisilin deri testleri yapılmalıdır. Hastalara mutlaka yeterli yazılı doküman verilmelidir.

Anahtar Kelimeler: Penisilin; ilaç allerjisi
ABSTRACT
As defined by World Health Organization, the unwanted or unexpected reaction that is caused by the medicine that is given in an appropriate dose and in order for diagnosis, treatment and protection is called "medicine reaction". The medicine reaction develops in immune and non-immune mechanisms. A group of medicine reaction that is developed within immune mechanisms is defined as "medicine allergy". Allergic medicine reactions, together with the most common form of skin reactions constitute 5-10% of the medicine side effects. It is presumed that the hospital expenses due to medicine reactions are 7000 per unit bed per year and morbidity and mortality costs are presumed to be more than 136 million dollars only in USA. Penicillin is found by Fleming in 1928. The Penicillins are the most frequently filled doctor's prescriptions and the antibiotics that are the most common reasons of medicine allergies. The Penicillin skin test, is developed right after the declaration of immunologic identifiers in 1960s and the penicillin allergy has remained the most accurate method in the determination of specific IgE antibody presence or absence. The penicillin allergy ratio is 1-10% and also the anaphylaxis ratio that threatens life is assumed to be in between 0,02% and 0,05%. Data on medicine reactions in childhood age group is very limited. Patients having a history of penicillin allergy or patients that have to be treated by penicillin or patients suspect with penicillin allergy and patients that are to be planned to be treated with antibiotics should be applied penicillin skin tests. Sufficient written documents should be given to the patients.

Keywords: Penicillin; drug hypersensitivity

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30.03.2014

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