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KMID : 0370220140580040229
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Yakhak Hoeji
2014 Volume.58 No. 4 p.229 ~ p.244
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Evaluation of Efficacy and Risk of Intradermal Skin Testing for Antibiotic Pharmacotherapy in Hospital of Korea
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Kim Kyeong-Ha
Lee Yun-Jeong
Lim Sung-Cil
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Abstract
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Background: Antibiotic skin test(AST) is very useful for the diagnosis of drug allergies to prevent immediate allergic reactions. Although it is a safe and widespread method, it is performed very diversely by doctors and nurses without consistency and it also differs from countries and hospitals. This study aims to evaluate the current practice of AST by nurses in Korea and to compare it to the general guidelines.
Methods: During January 1, 2013 to May 20, 2013, the study was conducted as questionnaires and case-based survey. The questionnaires were given to the nurses who were randomly selected in various University Hospitals (University Hospitals N=276, and Medical center N=19). The case-based surveys were given to the nurses who were conducting AST at various wards of a University Hospital (N=130). The analysis and evaluations of the responses were carried out.
Results: The response rate for the questionnaires was 97.6% and 130 cases of the actual case-based surveys were collected. There were clear differences between the survey results and the general guidelines, such as the method of skin test (skin prick test was not conducted), the method of patient selection for AST, test drugs, concentration, volume and interpretation of AST. AST conducted by nurses was highly variable and inconsistent, even among nurses who worked in the same wards and hospitals. Manufactured standard concentration antibiotic solution of AST showed consistency of concentration to a certain degree.
Conclusion: Although the general guidelines have been published by several countries including Korea, these are not a great help to nurses as they lack details for conducting AST, practical consideration for nurses in the clinical setting, propagation and education. Standardized guideline for nurses should be published and it should be a safe, clear, comfortable and easily accessible protocol. Futhermore, additional antibiotic solutions to standardize skin test should be developed and manufactured. Lastly, it would be the pharmacists role to compare their hospitals antibiotic skin test methods with the standard guidelines and develop a protocol within the hospital for patients’ safety, and to strive to consistently implement it.
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KEYWORD
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antibiotic skin test, immediate allergic reaction
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