{"id":114556,"date":"2018-03-11T10:42:36","date_gmt":"2018-03-11T10:42:36","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/reacciones-adversas-a-antiobioticos-betalactamicos-en-el-area-este-de-murcia\/"},"modified":"2018-03-11T10:42:36","modified_gmt":"2018-03-11T10:42:36","slug":"reacciones-adversas-a-antiobioticos-betalactamicos-en-el-area-este-de-murcia","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/epidemiologia\/reacciones-adversas-a-antiobioticos-betalactamicos-en-el-area-este-de-murcia\/","title":{"rendered":"Reacciones adversas a antiobi\u00f3ticos betalact\u00e1micos en el \u00e1rea este de murcia"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Carolina Merida Fernandez <\/strong><\/h2>\n<p>Resumen espa\u00f1ol de tesis doctoral  &quot;reacciones adversas a antibi\u00f3ticos betalact\u00e1micos en el \u00e1rea este de murcia&quot; carolina m\u00e9rida fern\u00e1ndez objetivos  las reacciones adversas a medicamentos suponen un aumento de morbilidad que lleva asociado un alto coste socioecon\u00f3mico mal evaluado. A esa morbilidad, se le a\u00f1ade la posibilidad del compromiso de la vida del paciente.  dada la magnitud y prospectiva de este creciente problema de salud, hemos decidido estudiarlo en la regi\u00f3n de murcia, donde no hay datos publicados de alergia a los antibi\u00f3ticos betalact\u00e1micos.  el objetivo de esta investigaci\u00f3n es conocer los datos reales y las caracter\u00edsticas de las reacciones adversas debidas al uso de antibi\u00f3ticos betalact\u00e1micos en el \u00e1rea este de la regi\u00f3n de murcia. estos datos podr\u00e1n ayudar a desarrollar medidas de prevenci\u00f3n oportunas para disminuir la incidencia, as\u00ed como servir de base para formular nuevas hip\u00f3tesis que puedan aclarar los factores implicados en la aparici\u00f3n de este problema de salud.  metodolog\u00eda fueron seleccionados todos los pacientes asistidos entre enero de 2001 y diciembre de 2010, en la secci\u00f3n de alergolog\u00eda del hospital universitario reina sof\u00eda, refiriendo alguna reacci\u00f3n adversa compatible con etiolog\u00eda al\u00e9rgica y relacionada con alg\u00fan antibi\u00f3tico betalact\u00e1mico. El \u00e1rea atendida por este hospital es el \u00e1rea vii (murcia\/este). Se incluyeron 435 pacientes. a esos pacientes, siguiendo el protocolo establecido en la secci\u00f3n de alergolog\u00eda, se les realiz\u00f3 una exhaustiva anamnesis que abarcaba desde antecedentes personales y familiares hasta las caracter\u00edsticas de la reacci\u00f3n adversa. Posteriormente, se realizaron determinaciones de ig e espec\u00edfica (penicilina g, penicilina v, amoxicilina, cefalosporinas); pruebas cut\u00e1neas (prick-tests e intradermoreacciones con los reactivos ppl (peniciloil polilisina) y mdm (mezcla de determinantes menores), penicilina g, amoxicilina y, en caso de ser otro antibi\u00f3tico betalact\u00e1mico el sospechoso, ese mismo antibi\u00f3tico). En los casos necesarios se realiz\u00f3 un test de exposici\u00f3n controlada con el medicamento sospechoso. Al concluir el estudio, los pacientes fueron catalogados como al\u00e9rgicos o no al\u00e9rgicos a los antibi\u00f3ticos betalact\u00e1micos.   conclusiones  1.- Se diagnostic\u00f3 de alergia a los antibi\u00f3ticos betalact\u00e1micos a 54 pacientes, un 13,71% de los que completaron el estudio.  2.-Los antibi\u00f3ticos betalact\u00e1micos implicados en las reacciones adversas con mayor frecuencia fueron amoxicilina-clavul\u00e1nico, penicilina y amoxicilina, por este orden. 3.- La mayor\u00eda de los pacientes se estudiaron transcurridos m\u00e1s de 2 a\u00f1os desde que ocurri\u00f3 la reacci\u00f3n. 4.-  Las reacciones adversas con betalact\u00e1micos predominan en el sexo femenino (63,45%).  5.-La v\u00eda oral fue la implicada con mayor frecuencia (65,17%) en la reacci\u00f3n adversa. 6.- Las reacciones inmediatas supusieron el 51,47% de los casos. 7.- Los s\u00edntomas cut\u00e1neos son los m\u00e1s referidos por los pacientes, principalmente urticaria-angioedema y  exantema generalizado. 8.- Solamente hubo una determinaci\u00f3n de ige espec\u00edfica positiva de 1209 realizadas. 9.- La t\u00e9cnica diagn\u00f3stica positiva m\u00e1s frecuente entre los diagnosticados de alergia a los  antibi\u00f3ticos betalact\u00e1micos fue la  intradermorreacci\u00f3n, seguida por la provocaci\u00f3n controlada. 10.- Los 6 pacientes diagnosticados de anafilaxia por penicilinas presentaron intradermorreacciones positivas, y las intradermorreacciones positivas con amoxicilina se relacionan significativamente con la anafilaxia como s\u00edntoma de presentaci\u00f3n. 11.- El diagn\u00f3stico m\u00e1s frecuente (44,44 %) fue el de urticaria\/angioedema por sensibilizaci\u00f3n a penicilinas, seguido por el de exantema general por sensibilizaci\u00f3n a penicilinas (16,67 %). 12.- El  diagn\u00f3stico de urticaria\/angioedema por sensibilizaci\u00f3n a penicilinas se relaciona significativamente con las intradermorreacciones con ppl y con amoxicilina positivas y con la provocaci\u00f3n con amoxicilina positiva.  resumen ingl\u00e9s de tesis doctoral  &quot;adverse drug reactions to betalactams antibiotics in the east area of  murcia&quot; carolina m\u00e9rida fern\u00e1ndez  background adverse drug reactions causes high morbility and socioeconomic costs that are poor evaluated. Sometimes, this high morbility can be associated with mortality.  ought to this growing health problem, we have decided to study it in murcia, where there is no information about allergy to betalactams antibiotics. the aim of this study was to know the characteristics of adverse drug reactions to betalactams in the east area of murcia.  this information could be useful to decrease the incidence of this health problem and to reduce its costs.    methods patients who attended to allergy section (reina sofia hospital) from january 2001 to december 2010 and who had suffered from adverse drug reaction to betalactams were included. The reaction must be compatible with an allergic reaction. 435 patients were included. following current protocols, we performed a clinical history (including clinical and family antecedents and characteristics of drug reaction), blood tests (specific ig e to penicillin g, penicillin v, amoxicillin and cefaclor) and skin tests (prick and intradermal test to ppl (penicilloyl-polylysine), mdm (minor determinant mixture), penicillin g, amoxicillin and the betalactam that caused the reaction). Drug provocation test were done when it was necessary. at the end of the investigation, patients were diagnosed from allergy or not allergy to betalactams antibiotics.    conclusions  1.- Fifty-four patients (13,71% of those who finished the study) were diagnosed from allergy to betalactams antibiotics.  2.-Amoxicillin-clavulanic, penicillin and amoxicillin were the most implicated betalactams in drug reactions following this order. 3.- Most patients were studied more than 2 years since the reaction happened. 4.- Drug reactions to betalactams were more frequent in women (63,45%).  5.-Oral administration was the most common in drug reactions (65,17%). 6.- Inmediate reactions reached  51,47%. 7.- Cutaneous reaction was the most frequent, mainly, urticaria-angioedema and generalized exanthema. 8.- We only found a positive specific ig e out of 1209 performed. 9.- The most useful diagnosis test was the intradermal test followed by drug provocation tests. 10.- Six patients were diagnosed from anaphylaxis due to penicillins. All of them presented positives  intradermal tests.  on the other hand, positive intradermal test to amoxicillin is statistically related to anaphylaxis. 11.- Urticaria-angioedema due to allergy to penicillins was the most common  diagnosis (44,44%), followed by generalized exanthema due to penicillins (16,67%). 12.- The diagnosis of urticaria\/angioedema due to sensitization to penicillins is statistically related to intradermal test positive to  ppl and amoxicillin and also to positive amoxicillin provocation test.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Reacciones adversas a antiobi\u00f3ticos betalact\u00e1micos en el \u00e1rea este de murcia<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Reacciones adversas a antiobi\u00f3ticos betalact\u00e1micos en el \u00e1rea este de murcia <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Carolina Merida Fernandez <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Murcia<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 22\/07\/2013<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Juan  Carlos Miralles Lopez<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: Francisco Guillen grima <\/li>\n<li>enrique Aguinaga ontoso (vocal)<\/li>\n<li>victor Soriano (vocal)<\/li>\n<li>Ana isabel Escudero pastor (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Carolina Merida Fernandez Resumen espa\u00f1ol de tesis doctoral &quot;reacciones adversas a antibi\u00f3ticos betalact\u00e1micos en el \u00e1rea este [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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