약물과민증 예방을 위한 처방전달 시스템 전산 프로그램의 이용

Abstract

Background: Drug hypersensitivity is difficult to predict, although it commonly occurs in medical practice. It can be prevented by avoidance of re-administration of causative drugs through a complete search for individual history of drug allergy. Objective: To investigate the epidemiological feature of drug hypersensitivity reported to the order communication system (OCS) and to evaluate the efficacy of a preventive program. Method: We developed computer-based surveillance system for drug hypersensitivity, ie. drug allergy and idiosyncrasy. Informations on the occurrence and patient’s history of drug hypersensitivity reactions, including symptoms, signs and the presumably causative drugs were inputted into OCS by doctors and nurses at Asan Medical Center from April through July of 2003. These informations were transferred to allergy specialists, and after their review, were automaticallynoticed on every prescribing process for the patients in the OCS. Result: Previous history of drug hypersensitivity was reported in 0.23% (48/20,525) of inpatients and 3.22% (61/ 1,892) of Allergy Clinic outpatients. The occurrence of drug hypersensitivity reactions was reported in 54 patients during the 4 months of monitoring thus the estimated incidence was 789/100,000 inpatients per year. Among them, past medical histories of drug hypersensitivity to the same causative drugs were identified retrospectively in 8 patients. Major causative drugs were antibiotics and radiocontrast dyes. Conclusion: For preventing the recurrence of drug hypersensitivity reaction, it is necessary to develop a mandatory computer program to register the patient’s history of drug hypersensitivity in the OCS.