为什么头孢菌素类不需做皮试.ppt

为什么头孢菌素类不需做皮试
为什么头孢菌素类不需做皮试为什么头孢菌素类不需做皮试为什么青霉素需要/可以做皮试?Approximately 300 deaths can be attributed to penicillin allergy each year in the United States.
Allergy to Beta Lactam Antibiotics July 26, 2007
 Fatal penicillin-induced anaphylaxis has been reported at a rate of % among the general population, with 500 to 1,000 deaths per year.
Arch Intern Med 2001:161:15~21
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为什么青霉素需要/可以做皮试?
Approximately 300 deaths can be attributed to penicillin allergy each year in the United States.
Allergy to Beta Lactam Antibiotics July 26, 2007
 Fatal penicillin-induced anaphylaxis has been reported at a rate of % among the general population, with 500 to 1,000 deaths per year.
Arch Intern Med 2001:161:15~21
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Classification Scheme for Adverse Drug Reactions Described by Gell and Coombs
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Types of Allergic Reactions to Penicillins and Cephalosporins
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氟氯西林致过敏的斑丘疹
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氨苄西林致敏的荨麻疹
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为什么青霉素需要/可以做皮试?
1,青霉素过敏反应发生率较高,为1%-10%;%–%(%),即1/7,000-25,000,死亡率为1/50,000-60,000;
2,过敏反应的抗原—主要决定簇-青霉噻唑决定簇与次要决定簇-青霉烯酸决定簇非常明确;
3,皮试符合率可达70%; 但是—
Penicillin skin testing does not provide any information about certain types of reactions;
 skin tests show that only a small percentage actually are reactive to these antibiotics.
4,皮试液的浓度与皮试方法均已定型。
5,80%~90%青霉素过敏史者，再次皮试可为阴性,因IgE可逐渐消失;
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N Engl J Med 2006;354:601-9.
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青霉素变态反应主要/次要决定簇明确
N Engl J Med 2006;354:601-9
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为什么准确率仅能达到70%?
The breakdown products of penicillin include the penicilloyl group, known as the major determinant because it is the major penicillin metabolic product (approximately 85% to 90% of the penicillin breakdown products).
The minor haptenic determinants or minor determinant mixture, so called because they are formed in smaller quantities, are composed of the parent penicillin molecules, penicilloate, penicilloylamine, penilloate, and other simple chemical products of penicillin.
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为什么准确率仅能达到70%?
A penicillin s