Background Non-ionic radiocontrast media (RCM) is rarely associated with hypersensitivity reactions. Premedication of patients who reacted previously to RCM with systemic corticosteroids and/or antihistamines can help reduce recurrent hypersensitivity reactions. However, premedication is still not prescribed in many cases for various reasons. This study aimed to determine the effectiveness of our novel RCM hypersensitivity surveillance and automatic recommending system for premedication. Methods and Results Hospitalized patients with a history of RCM hypersensitivity were identified in an electronic medical record system that included a mandatory reporting system for past adverse drug reactions. In 2009, a novel automatic prescription system was added that classified index RCM reactions by severity and dispensed appropriate corticosteroid and/or antihistamine pretreatment prior to new RCM exposures. The data from 12 months under the previous system and 12 months under the current system were compared. The two systems had similar overall premedication rates (91% and 95%) but the current system was associated with a significantly higher corticosteroid premedication rate (65% vs. 14%), which significantly reduced the breakthrough reaction rate (6.7% vs. 15.2%). The current system was also associated with increased corticosteroid and antihistamine premedication of patients with a mild index reaction (61% vs. 7%) and a reduction in their breakthrough reaction rate (6% vs. 15%). Conclusions Premedication with corticosteroid and/or antihistamine, which was increased by our novel automatic prescription system, significantly reduced breakthrough reactions in patients with a history of RCM hypersensitivity.
The Effectiveness of Automatic Recommending System for Premedication in Reducing Recurrent Radiocontrast Media Hypersensitivity Reactions
Yun-Jeong Bae,Y. Hwang,Sun-young Yoon,Sujeong Kim,Taehoon Lee,Yoon Su Lee,Hyouk-Soo Kwon,Y. Cho,M. Shin,H. Moon,Tae-Bum Kim
Published 2013 in PLoS ONE
ABSTRACT
PUBLICATION RECORD
- Publication year
2013
- Venue
PLoS ONE
- Publication date
2013-06-19
- Fields of study
Medicine
- Identifiers
- External record
- Source metadata
Semantic Scholar, PubMed
CITATION MAP
EXTRACTION MAP
CLAIMS
CONCEPTS
- antihistamine premedication
Use of antihistamines as pre-exposure prophylaxis before radiocontrast media administration.
- automatic prescription system
An electronic medical record-based system that automatically recommends and dispenses premedication before new radiocontrast media exposure based on the severity of prior reactions.
Aliases: automatic recommending system
- breakthrough reaction
A hypersensitivity reaction occurring despite premedication during a subsequent radiocontrast media exposure.
- corticosteroid premedication
Use of systemic corticosteroids as pre-exposure prophylaxis before radiocontrast media administration.
Aliases: steroid premedication
- mild index reaction
An initial radiocontrast media hypersensitivity reaction classified as mild in the severity-based reporting system.
Aliases: mild index RCM reaction
- premedication
Preventive administration of medication before repeat radiocontrast media exposure in patients with prior hypersensitivity.
- radiocontrast media hypersensitivity
A prior hypersensitivity history related to non-ionic radiocontrast media exposure.
Aliases: RCM hypersensitivity
REFERENCES
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CITED BY
Showing 1-34 of 34 citing papers · Page 1 of 1