中国药物警戒 ›› 2025, Vol. 22 ›› Issue (7): 809-811.
DOI: 10.19803/j.1672-8629.20240761

• 安全与合理用药 • 上一篇    下一篇

注射用头孢噻肟钠舒巴坦钠致迟发型超敏反应1例分析

林璐1, 赵安职1, 陈锦辉1, 李忠文2, 黄国华3, 钟诗龙1,*   

  1. 1南方医科大学附属广东省人民医院,广东省医学科学院药学部,广东 广州 510000;
    2南方医科大学附属广东省人民医院,广东省医学科学院内分泌科,广东 广州 510000;
    3南方医科大学附属广东省人民医院,广东省医学科学院呼吸科,广东 广州 510000
  • 收稿日期:2024-09-30 出版日期:2025-07-15 发布日期:2025-07-17
  • 通讯作者: *钟诗龙,男,博士,研究员,医院药学与药事管理。E-mail: shz2020@qq.com
  • 作者简介:林璐,女,硕士,主管药师,临床药学。
  • 基金资助:
    广东省医院协会药学科研专项基金（2021YSQN02）

One Case of Delayed Hypersensitivity Reactions Caused by Cefotaxime Sodium and Sulbactam Sodium for Injection

LIN Lu1, ZHAO Anzhi1, CHEN Jinhui1, LI Zhongwen2, HUANG Guohua3, ZHONG Shilong1,*   

  1. 1Department of Pharmacy, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou Guangdong 510000, China;
    2Department of Endocrinology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou Guangdong 510000, China;
    3Department of Respiratory Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou Guangdong 510000, China
  • Received:2024-09-30 Online:2025-07-15 Published:2025-07-17

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摘要： 目的 探讨注射用头孢噻肟钠舒巴坦钠致迟发型超敏反应的临床特征、判断方法和治疗策略,为临床安全用药提供参考。方法 分析1例使用注射用头孢噻肟钠舒巴坦钠后发生迟发型超敏反应的病例,归纳总结相关处理方案。结果 患者因间断性干咳被诊断为肺占位性病变并伴有2型糖尿病,在接受包括头孢噻肟钠舒巴坦钠在内的综合性治疗6 d后,出现了超敏反应,临床表现为双下肢和面部皮疹伴瘙痒,鉴于症状与头孢噻肟钠舒巴坦钠已知不良反应症状和注射时间的高度相关性,故怀疑是该药致迟发型超敏反应,随即停用该药并予抗过敏治疗,患者症状缓解,生命体征平稳。结论 应注意头孢噻肟钠舒巴坦钠的迟发型超敏反应风险,其特点是有一定的潜伏期,应加强观察,综合判断,及时停药,必要时予抗过敏治疗。

关键词: 头孢噻肟钠舒巴坦钠, 迟发型超敏反应, 药品不良反应, 第三代头孢菌素, 皮疹

Abstract: Objective To analyze the clinical characteristics of delayed hypersensitivity reactions induced by cefotaxime sodium and sulbactam sodium and to devise diagnostic approaches and therapeutic strategies in order to provide evidence-based references for safe clinical medications. Methods One clinical case that presented with delayed hypersensitivity reactions following cefotaxime sodium and sulbactam sodium for injection administration was analyzed before management protocols were formulated based on literature and evidence. Results A patient with intermittent dry cough was diagnosed with a pulmonary space-occupying lesion comorbid with type 2 diabetes mellitus. After six days of combined therapy with cefotaxime sodium and sulbactam sodium, the patient developed pruritic erythematous rashes on bilateral lower extremities and across facial regions. The temporal correlation between drug administration and symptom onset, coupled with the characteristic manifestation pattern consistent with established adverse drug reaction profiles, strongly suggested delayed hypersensitivity reactions attributed to cefotaxime sodium and sulbactam sodium. Immediate discontinuation of the suspected agent combined with antihistamine therapy resulted in complete resolution of cutaneous manifestations and stabilization of vital signs. Conclusion Clinicians should remain vigilant against the risk of delayed hypersensitivity reactions associated with cefotaxime sodium and sulbactam sodium. These reactions exhibit distinct latency periods that may complicate causal attribution, potentially leading to misdiagnosis. Enhanced clinical monitoring, comprehensive causality assessment, prompt withdrawal of suspected agents and coupled with antihistamine therapy when necessary are crucial to optimizing patient outcomes.

Key words: Cefotaxime Sodium and Sulbactam Sodium, Delayed Hypersensitivity Reaction, Adverse Drug Reaction, Third-Generation Cephalosporins, Exanthema

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