Re: [申覆]醫學三 第59題
※ 引述《YoWang (Yo)》之銘言：
: 有關PCT
: (B)以前用過Penicillin 沒有過敏就不需要做皮膚測試了嗎?
: 記得當intern應該沒有問過敏都是routine做PCT了吧
: 跟病房Routine的工作好像有違背
Clinical history as a predictor of penicillin skin test outcome
Annals of Allergy, Asthma and Immunology 97 (2), pp. 169-174 (IF: 2.22)
Background: Up to 10% of the population reports an "allergy" to penicillin,
whereas approximately 1.1% has positive penicillin skin lest results. Where
penicillin skin tests are unavailable, some have advocated using history to
decide whether to use a penicillin-related antibiotic. Objective: To
determine if clinical history predicts penicillin skin test results. Method:
Retrospective medical record review of 94 consecutive patients who had
previously taken penicillin referred for penicillin allergy. Case histories
were taken, penicillin skin tests performed, and an oral challenge
recommended if skin test results were negative. Results: Of 91 cases studied,
the average patient age was 27 years (range, 6 months to 82 years; 36%
female). Fifty-two (57%) experienced hives as their main adverse reaction.
Sixteen (18%) had at least 1 positive test result. Of this group, 9 had hives
as their main symptom, whereas 1 had respiratory problems and 1 had
angioedema. Most patients with positive skin lest results had experienced
their reaction at least 3 years ago. Regression analysis showed that age,
sex, and clinical history, including type of reaction, time of reaction after
penicillin ingestion, or time since the last reaction, were not associated
with skin test positivity. Seventy-two (96%) of the 75 patients who had
negative skin test results underwent oral challenge. Seventy had negative
challenge results. The negative predictive value of a negative penicillin
skin test result was 97%, Conclusion: Clinical history was not predictive of
subsequent penicillin skin test results.
很虛…我知道
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08/04 16:33, , 1F
08/04 16:33, 1F
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