薬剤性肺炎の最近の動向と問題点

Abstract

In recent years, the number of drug-induced cases of pneumonitis have been reporled to increase. In this study, a literature-based investigation was performed to review the cases reported after Tomioka's study. Moreover, the reported cases in Tokyo Metropolitan Tama Geriatric Hospital, National Tokyo Hospital and Seire Hamamatu Hospital were also retrospectively reviewed.1. Between July 1993 and December 1996, 180 cases of drug-induced pneumonitis were reported in the domestic literatures. Twenty-one of which were related to antineoplastics or immunosuppressants while 49 cases were caused by antibiotics. Among the remaining 110 cases, interferon (s), herbal remedies and cold preparations constitued 34, 26, and 5 cases respectively. Within the 26 herbal remedy-induced cases, 21 of them were due to Shosaikoto. A whole variety of drugs including GCSF and an increased number of drugs were reported.2. In the three hospitals, similar distributions of drug-induced pneumonitis cases were shown with the majority related to herbal remedies and interferon (s).3. According to the reports in the literature and from the three hospital, the results of treatments and prognosis were related to the discontinuation of the suspected agents. Consequently, early detection and discontinuation of causative agents can improve the prognoses of drug-induced pneumonitis.In order to detect drug-induced pneumonitis at an early stage, a database on the characteristics of the causative drugs should be systemically established and be readily available to health care professionals. Moreover, the early implementation of a centralized medication history system will facilitate the tracking of the causes of such drug-induced diseases.