Vol.54 No.4 July 2006
Discontinuation of intracutaneous reaction test -A questionnaire survey of surgery departments-
3rd Department of Surgery, Toho University School of Medicine,
2-17-6 Ohashi, Meguro-ku, Tokyo, Japan
Abstract
In Japan, the intracutaneous reaction test has been regarded as mandatory, when any antibiotics is administered intravenously. The policy is not based on evidence, but on custom. The value of this test to the detection of anaphylaxis has been questioned, but no evidence suggesting otherwise has been found. In 2003, Japanese Society of Chemotherapy summarized evidence on anaphylaxis associated with the administration of antibiotics and recommended that the intracutaneous reaction test be abolished. We conducted a questionnaire to collect data on how physicians responded to this change. We sent questionnaire to 527 departments and received 274 answers. Fifty-four percent of the departments had discontinued or were preparing to stop using the intracutaneous reaction test, while 18% of them are described still continued to use the test. Among the departments that hesitated to stop using the test, one of the biggest concerns was how to observe patients. In the guideline on measure for anaphylaxis as a result of antibiotics use, which were published by the Japanese Society of Chemotherapy, observation is required during the administration of antibiotics. Practically, such observation can be difficult, because of staff shortage at many Japanese hospitals. Moreover, some physicians misunderstood that it was not necessary to observe patients, if an intracutaneous reaction test was conducted. The reason for the discontinuation of the test dose not appears to be widely known. Adverse events caused by anaphylaxis should be surveyed, the guideline should be reassessed, if necessary.
Key word
questionnaire survey, antimicrobial agent, intracutaneous reaction test
Received
February 14, 2006
Accepted
April 7, 2006
Jpn. J. Chemother. 54 (4): 315-320, 2006
