ANTI-INFECTIVE DRUG-USE IN RELATION TO THE RISK OF AGRANULOCYTOSIS AND APLASTIC-ANEMIA - A REPORT FROM THE INTERNATIONAL AGRANULOCYTOSIS AND APLASTIC-ANEMIA STUDY
ANTI-INFECTIVE DRUG-USE IN RELATION TO THE RISK OF AGRANULOCYTOSIS AND APLASTIC-ANEMIA - A REPORT FROM THE INTERNATIONAL AGRANULOCYTOSIS AND APLASTIC-ANEMIA STUDY
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DOI：
10.1001/archinte.149.5.1036
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发表时间：
1989-05-01
影响因子：
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通讯作者：
KAUFMAN, DW
中科院分区：
文献类型：
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作者：
KAUFMAN, DW
在欧洲和以色列进行的一项基于人群的病例对照研究估计了与使用抗感染药物有关的粒细胞缺乏症和再生障碍性贫血的风险。比较251例因粒细胞缺乏症住院的患者和1271例因与既往使用抗感染药物无关的原因住院的对照患者发病前2周内抗感染药物的使用情况。当连续使用至少3天时，与粒细胞缺乏症显著相关的抗感染药物是甲氧苄啶/磺胺甲恶唑（相对危险度为12；95%可信区间为3.9至40）和大环内酯类药物（.infin）。不使用甲氧苄氨嘧啶的磺胺类药物的相对风险估计值升高，但没有统计学意义（3.6；0.7至18）。这些估计考虑到各种因素的混杂，特别是其他药物的使用。在2周内使用甲氧苄氨嘧啶/磺胺甲恶唑和大环内酯类药物导致的粒细胞缺血症的估计超额风险分别为1.6 /百万分之和7.1 /百万分之。对135例再生障碍性贫血患者和1410例对照患者入院前29- 180天抗感染药物使用情况进行比较。尽管甲氧苄啶/磺胺类药物的相对风险点估计值升高（2.1），其他磺胺类药物（2.9）和。-内酰胺（1.5），无统计学意义。
The risks of agranulocytosis and aplastic anemia in relation to the use of anti-infective drugs were estimated in a population-based case-control study conducted in Europe and Israel. Anti-infective drug use in the 2-week period before the onset of illness was compared between 251 patients admitted to hospital with agranulocytosis and 1271 controls hospitalized for reasons judged to be unrelated to previous use of anti-infective drugs. Anti-infectives significantly associated with agranulocytosis when used for at least 3 consecutive days were trimethoprim/sulfamethoxazole (relative risk, 12; 95% confidence interval, 3.9 to 40) and macrolides (.infin.). The relative risk estimate for any use of sulfonamides without trimethoprim was elevated, but not statistically significant (3.6; 0.7 to 18). These estimates took confounding by various factors, in particular the use of other drugs, into account. The estimated excess risks of agranulocytosis attributable to the use of trimethoprim/sulfamethoxazole and macrolides in a 2-week period were 1.6 and 7.1 per million, respectively. Anti-infective use during the 29- through 180-day period before hospital admission was compared between 135 patients with aplastic anemia and 1410 controls. Although relative risk point estimates were elevated for trimethoprim/sulfonamides (2.1), other sulfonamides (2.9), and .beta.-lactams (1.5), none was statistically significant.