Abstract
BackgroundCefaclor, a second-generation oral cephalosporin, is widely prescribed to treat infectious diseases. Immediate hypersensitivity (HS) reactions to cefaclor have continuously been reported and are expected to increase with its greater use. This study aimed to investigate the clinical characteristics and risk factors of immediate HS to cefaclor over the most recent 5 years.MethodsThis retrospective study investigated 521 adverse drug reactions (ADRs) to cefaclor at pharmacovigilance centers at two tertiary hospitals from January 2014 to December 2018. In total, 459 patients with immediate HS to cefaclor were reviewed.ResultsA total of 459 cases of cefaclor immediate HS were included among 521 cefaclor ADRs, and anaphylaxis was recorded in 61.2%. Female sex (odds ratio 2.917, 95% confidence interval 2.397–3.550, P < 0.001), age under 65 years (4.225, 3.017–5.916, P < 0.001), hypertension (2.520, 1.875–3.388, P < 0.001), liver diseases (2.189, 1.208–3.967, P = 0.010), asthma (8.075, 5.301–12.302, P < 0.001), and concomitant use of nonsteroidal anti-inflammatory drugs (1.888, 1.554–2.294, P < 0.001) were significantly associated with cefaclor immediate HS.ConclusionsCefaclor was found to elicit high proportions of immediate HS and anaphylaxis. Physicians ought to be cautious with prescribing cefaclor to females, individuals with hypertension, liver diseases, or asthma, and patients taking nonsteroidal anti-inflammatory drugs.Trial registrationThis study was retrospectively registered.
Highlights
IntroductionA second-generation oral cephalosporin, is widely prescribed to treat infectious diseases
Cefaclor, a second-generation oral cephalosporin, is widely prescribed to treat infectious diseases
Clinical characteristics of the study subjects A total of 521 cefaclor adverse drug reaction (ADR) were recorded during the study period
Summary
A second-generation oral cephalosporin, is widely prescribed to treat infectious diseases. This study aimed to investigate the clinical characteristics and risk factors of immediate HS to cefaclor over the most recent 5 years. According to Health Insurance Review and Assessment Service data, the prescription of cefaclor has continued to increase since 2015 in Korea [11], and an increase in ADRs related to cefaclor is expected: cefaclor ADRs have been reported continuously [5, 12,13,14,15,16,17], and cefaclor has been found to be the most common causative drug of anaphylaxis [18]. We investigated clinical characteristics and risk factors of cefaclor immediate HS, including anaphylaxis, for the most recent 5 years in Korea
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