BibTex RIS Kaynak Göster

Penicillin Therapy in Children with Acute Rheumatic Fever: Side Effects, Malpractice and Anaphylactic Reactions

Yıl 2015, Cilt: 13 Sayı: 1, 31 - 39, 01.06.2015
https://doi.org/10.4274/jcp.46330

Öz

Acute rheumatic fever ARF is more common in developing countries. ARF is a systemic disorder, which develops in children following group A streptococcal GAS pharyngitis. Rheumatic valvular disease is caused by autoimmune responses. Penicillin is used in the treatment of GAS tonsillopharyngitis and in primary and secondary prophylaxis against ARF. A single intramuscular IM injection of benzathine penicillin or oral penicillin V phenoxymethylpenicillin is administered as primary prophylaxis for 10 days. In the presence of rheumatic valvular disease, secondary prophylaxis with the injection of benzathine penicillin is required for life, or at least until the age of 40. IM injection of penicillin may cause fear and pain in children. Lidocaine or lidocaine-prilocaine EMLA creams can be used to decrease pain associated with IM injections. The most serious side effect of penicillin is, however, the anaphylactic reaction. This reaction can be caused by minor or major determinants of penicillin. Patients should be questioned about the past history of the penicillin allergy, and penicillin skin testing should be performed and interpreted appropriately in order to prevent anaphylactic reaction related to penicillin administration. In the presence of the suspicion of a penicillin allergy, skin testing should be avoided, and the patient should be tested by a pediatric allergy specialist using major and minor determinants to confirm a penicillin allergy. Patients who are allergic to penicillin can undergo desensitization in the absence of an alternative drug. It is a medical and legal obligation to perform and interpret the skin test appropriately, to keep the necessary equipment and drugs available for possible anaphylactic reactions, and to treat the patient appropriately in the case of an anaphylactic reaction. Penicillin is commonly used in pediatrics and pediatric cardiology

Kaynakça

  • 1. Shaikh N, Leonard E, Martin JM. Prevalence of streptococcal pharyngitis and streptococcal carriage in children: a meta￾analysis. Pediatrics 2010;126:557-64.
  • 2. Kaplan EL, Huew BB. The sensitivity and specificity of an agglutination test for antibodies to streptococcal extracellular antigens: A quantitative analysis and comparison of the Streptozyme test with the anti-streptolysin O and anti￾deoxyribonuclease B tests. J Pediatr 1980;96:367-73.
  • 3. Veasy LG, Wiedmeier SE, Orsmond GS, Ruttenberg HD, Boucek MM, Roth SJ, et al. Resurgence of acute rheumatic fever in the intermountain area of the United States. New Engl J Med 1987;316:421-27.
  • 4. Veasy LG, Tani LY, Hill HR. Persistence of acute rheumatic fever in the intermountain area of the United States [see comments]. J Pediatr 1994;124:9-16.
  • 5. McIsaac WJ, White D, Tannenbaum D, Low DE. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ 1998;158:75-83.
  • 6. Leung AK, Newman R, Kumar A, Davies HD. Rapid antigen detection testing in diagnosing group A beta-hemolytic streptococcal pharyngitis. Expert Rev Mol Diagn 2006;6:761-6.
  • 7. Kimball TR, Michelfelder EC. Echocardiography. In: Allen HD (eds). Moss and Adams’ heart disease in infants, children, and adolescents: including the fetus and young adult, Seventh Edition. Lippincott Williams & Wilkins, Philadelphia, 2008:95-163.
  • 8. Marijon E, Mirabel M, Celermajer DS, Jouven X. Rheumatic heart disease. Lancet 2012;379:953-64.
  • 9. Breda L, Marzetti V, Gaspari S, Del Torto M, Chiarelli F, Altobelli E. Population-based study of incidence and clinical characteristics of rheumatic Fever in abruzzo, central Italy, 2000- 2009. J Pediatr 2012;160:832-6.
  • 10. Orün UA, Ceylan O, Bilici M, Karademir S, Ocal B, Senocak F. Acute rheumatic fever in the Central Anatolia Region of Turkey: a 30-year experience in a single center. Eur J Pediatr 2012;171:361-8.
  • 11. Ekici F, Kale Y, Kocabaş A. [Changing face of acute rheumatic fever: our clinical observations]. Anadolu Kardiyol Derg 2013;13:506-7.
  • 12. Anita K. M, Zaidi and Donald A. Goldman. Rheumatic fever in The Nelson Textbook of Pediatrics. Kliegman RM, Behrman RE, Jenson HB (eds). WB Saunders Company. 18 th edition. Philadelphia 2007:1140-45.
  • 13. Dajani A, Taubert K, Ferrieri P, Peter G, Shulman S. Treatment of acute streptococcal pharyngitis and prevention of rheumatic fever: a statement for health professionals. Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young, the American Heart Association. Pediatrics 1995;96:758-64.
  • 14. Shulman ST. Acute streptococcal pharyngitis in pediatric medicine: current issues in diagnosis and management. Paediatr Drugs 2003;5:13-23.
  • 15. Thatai D, Turi ZG. Current guidelines for the treatment of patients with rheumatic fever. Drugs 1999;57:545-55.
  • 16. Câmara EJ, Neubauer C, Câmara GF, Lopes AA. Mechanisms of mitral valvar insufficiency in children and adolescents with severe rheumatic heart disease: An echocardiographic study with clinical and epidemiological correlations. Cardiol Young 2004;14:527-32.
  • 17. Tompkins DG, Boxerbaum B, Liebman J. Long-term prognosis of rheumatic fever patients receiving regular intramuscular benzathine penicillin. Circulation 1972;45:543-51.
  • 18. Spagnuolo M, Pasternack B, Taranta A. Risk of rheumatic-fever recurrences after streptococcal infections. Prospective study of clinical and social factors. N Engl J Med 1971;285:641-7.
  • 19. Massell BF. Factors in the pathogenesis of rheumatic fever recurrences. J Maine Med Assoc 1962;53:88-93.
  • 20. Feinstein AR, Spagnuolo M. The clinical patterns of acute rheumatic fever: A reappraisal. Medicine 1962;41:279-305.
  • 21. Kaplan EL, Berrios X, Speth J, Siefferman T, Guzman B, Quesny F. Pharmacokinetics of benzathine penicillin G: Serum levels during the 28 days after intramuscular injection of 1,200,000 units. J Pediatr 1989;115:146-50.
  • 22. Oran B, Tastekin A, Karaaslan S, Bas L, Ayçiçek A, Ceri A, et al. Prophylactic efficiency of 3-weekly benzathine penicillin G in rheumatic fever. Indian J Pediatr 2000;67:163-7.
  • 23. Hodes RM. Recurrence of rheumatic fever after valve replacement. Cardiology 1989;76:465-8
  • 24. Nishimura RA, Carabello BA, Faxon DP, Freed MD, Lytle BW, O’Gara PT, et al. ACC/AHA 2008 Guideline update on valvular heart disease: focused update on infective endocarditis: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2008;52:676-85
  • 25. Monarch. Bicillin C-R (penicillin G benzathine and penicillin G procaine) injectable suspension disposable syringe 4 mL for deep IM injection only prescribing information. Bristol, TN; 2004 Jun.
  • 26. Farhadi A, Esmailzadeh M. Effect of local cold on intensity of pain due to Penicillin Benzathin intramuscular injection. International Journal of Medicine 2011;3:343-45.
  • 27. Schichor A, Bernstein B, Weinerman H, Fitzgerald J, Yordan E, Schechter N. Lidocaine as a diluent for ceftriaxone in the treatment of gonorrhea. Does it reduce the pain of the injection? Arch Pediatr Adolesc Med 1994;148:72-5.
  • 28. Christoph RA, Buchanan L, Begalla K, Schwartz S. Pain reduction in local anesthetic administration through pH buffering. Ann Emerg Med 1988;17:117-20.
  • 29. Amir J, Ginat S, Cohen YH, Marcus TE, Keller N, Varsano I. Lidocaine as a diluent for administration of benzathine penicillin G. Pediatr Infect Dis J 1998;17:890-3.
  • 30. Patel IH, Weinfeld RE, Konikoff J, Parsonnet M. Pharmacokinetics and tolerance of ceftriaxone in humans after single-dose intramuscular administration in water and lidocaine diluents. Antimicrob Agents Chemother 1982;21:957-62.
  • 31. Buhse M. Efficacy of EMLA cream to reduce fear and pain associated with interferon beta-1a injection in patients with multiple sclerosis. J Neurosci Nurs 2006;38:222-6.
  • 32. Taketomo CK, Hodding JH, Kraus DM. Pediatric dosage handbook. 12. Edition. Lexi Comp. 2005:986-93.
  • 33. Kök AN, Güler M, Çalangu S. Hekimlikte malpraktis. ANKEM Derg 2003;17:345-51.
  • 34. Joint Task Force on Practice Parameters. American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology; Joint Council of Allergy, Asthma and Immunology. Ann Allergy Asthma Immunol 2010;105:259-73.
  • 35. Kahn DA, Solensky R. Drug allergy. J Allergy Clin Immunol 2010;125:126-37.
  • 36. Karaman Ö, Babayiğit A, Ölmez D. Anafilaksi Nedenleri, Tanısı ve Tedavisi. Güncel Pediatri 2006;2:8-12.
  • 37. Pichler WJ, Adam J, Daubner B, Gentinetta T, Keller M, Yerly D. Drug hypersensitivity reactions: pathomechanism and clinical symptoms. Med Clin North Am 2010;94:645-64.
  • 38. Adkinson FN, Bochner SB, Busse WW, Holgate TS, Remanske FR, Simons REF. Middleton’s Allergy principles and practice. 7 th ed. St.Louis: Mosby Elsevier, 2009:1205-26.
  • 39. Segal AR, Doherty KM, Leggott J, Zlotoff B. Cutaneous reactions to drugs in children. Pediatrics 2007;120:1082-96.
  • 40. Romano A, Torres MJ, Castells M, Sanz ML, Blanca M. Diagnosis and management of drug hypersensitivity reactions. J Allergy Clin Immunol 2011;127:67-73.
  • 41. Schnyder B. Approach to the patient with drug allergy. Immunol Allergy Clin North Am 2009;29:405-18.
  • 42. Fontaine C, Mayorga C, Bousquet PJ. Relevance of the determination of serum-specific IgE antibodies in the diagnosis of immediate beta-lactam allergy. Allergy 2007;62:47-52.
  • 43. Aberer W, Birger K. Provocation test in drug hypersensitivity. Immunol Allergy Clin North Am 2009;29:567-84.
  • 44. Romano A, Gaeta F, Valluzzi RL, Caruso C, Rumi G, Bousquet PJ. IgE-mediated hypersensitivity to cephalosporins: cross￾reactivity and tolerability of penicillins, monobactams, and carbapenems. J Allergy Clin Immunol 2010;126:994-9.
  • 45. Antico A, Pagani M, Compalati E, Vescovi PP, Passalacqua G. Risk Assessment of Immediate Systemic Reactions from Skin Tests with β-Lactam Antibiotics. Int Arch Allergy Immunol 2011;156:427-33.
  • 46. Leung M Y D, Sampson H, Geha R. Pediatric Allergy, 2nd ed. Saunders Elsevier, 2010:616-48.
  • 47. Simons FE, Ardusso LR, Dimov V, Ebisawa M, El-Gamal YM, Lockey RF, et al. World allergy organization anaphylaxis guidelines: 2013 update of the evidence base. Int Arch Allergy Immunol 2013;162:193-204.
  • 48. Sampson HA, Munoz-Furlong A, Campbell RL, Adkinson NF Jr, Bock SA, Branum A, et al. Second symposium on the definition and management of anaphylaxis: summary report - Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network Symposium. J Allergy Clin Immunol 2006;117:391-7.
  • 49. Vadas P, Perelman B, Liss G. Platelet-activating factor, histamine, and tryptase levels in human anaphylaxis. J Allergy Clin Immunol 2013;131:144-49.
  • 50. Soar J, Deakin CD, Nolan JP, Abbas G, Alfonzo A, Handley AJ, et al. European Resuscitation Council guidelines for resuscitation 2005, Section 7. Cardiac arrest in special circumstances. Resuscitation 2005;6751:135-70.

Akut Romatizmal Ateşli Çocuklarda Penisilin Tedavisi: Yan Etkileri, Malpraktis ve Anaflaktik Reaksiyon

Yıl 2015, Cilt: 13 Sayı: 1, 31 - 39, 01.06.2015
https://doi.org/10.4274/jcp.46330

Öz

Akut romatizmal ateş ARA gelişmekte olan ülkelerde daha sıktır. ARA sistemik bir hastalık olup çocuklarda grup A streptokok GAS farenjitinden sonra gelişir. Romatizmal kapak hastalığı otoimmün cevap sonucu oluşur. Penisilin GAS ile oluşan tonsillofarenjitin tedavisinde, ARA’nın primer ve sekonder proflaksisinde kullanılmaktadır. Primer proflakside tek doz intramüsküler İM benzatin penisilin veya oral penisilin V fenoksimetilpenisilin 10 gün süre ile verilir. Romatizmal kapak hastalığı mevcut ise en az 40 yaşına kadar veya yaşam boyu benzatin penisilin ile sekonder proflaksi uygulamak gerekir. Penisilin İM enjeksiyonu çocuklarda korkuya ve ağrıya neden olabilir. İM enjeksiyon sırasında ağrıyı azaltmak için lidokain veya lidokain-prilokain EMLA krem kullanılabilir. Penisilinin en ciddi yan etkisi anaflaktik reaksiyondur. Anaflaktik reaksiyon penisilinin majör veya minör determinantı ile oluşabilir. Penisiline bağlı anaflaksiyi önlemek için penisilin alerjisini iyi sorgulamak ve deri testini uygun olarak yapmak ve yorumlamak gerekir. Penisilin alerji şüphesi varsa deri testi yapmadan hastaların pediatrik alerji tarafından majör ve minör determinant kullanılarak yapılan testler ile değerlendirilmesi ve penisilin alerjisinin aydınlatılması gerekir. Penisilin allerjisi olanlarda alternatif ilaç yokluğunda desensitizasyon yapılabilir. Penisilin uygulanırken deri testinin uygun şekilde yapılması ve yorumlanması, olası anaflaksi reaksiyona müdahale için gerekli malzemenin ve ilaçların hazırda bulundurulması ve anaflaksiye uygun müdahalenin yapılması tıbbi ve yasal açıdan önemlidir. Penisilin pediatri ve pediatrik kardiyolojide sık kullanılan bir ilaçtır

Kaynakça

  • 1. Shaikh N, Leonard E, Martin JM. Prevalence of streptococcal pharyngitis and streptococcal carriage in children: a meta￾analysis. Pediatrics 2010;126:557-64.
  • 2. Kaplan EL, Huew BB. The sensitivity and specificity of an agglutination test for antibodies to streptococcal extracellular antigens: A quantitative analysis and comparison of the Streptozyme test with the anti-streptolysin O and anti￾deoxyribonuclease B tests. J Pediatr 1980;96:367-73.
  • 3. Veasy LG, Wiedmeier SE, Orsmond GS, Ruttenberg HD, Boucek MM, Roth SJ, et al. Resurgence of acute rheumatic fever in the intermountain area of the United States. New Engl J Med 1987;316:421-27.
  • 4. Veasy LG, Tani LY, Hill HR. Persistence of acute rheumatic fever in the intermountain area of the United States [see comments]. J Pediatr 1994;124:9-16.
  • 5. McIsaac WJ, White D, Tannenbaum D, Low DE. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ 1998;158:75-83.
  • 6. Leung AK, Newman R, Kumar A, Davies HD. Rapid antigen detection testing in diagnosing group A beta-hemolytic streptococcal pharyngitis. Expert Rev Mol Diagn 2006;6:761-6.
  • 7. Kimball TR, Michelfelder EC. Echocardiography. In: Allen HD (eds). Moss and Adams’ heart disease in infants, children, and adolescents: including the fetus and young adult, Seventh Edition. Lippincott Williams & Wilkins, Philadelphia, 2008:95-163.
  • 8. Marijon E, Mirabel M, Celermajer DS, Jouven X. Rheumatic heart disease. Lancet 2012;379:953-64.
  • 9. Breda L, Marzetti V, Gaspari S, Del Torto M, Chiarelli F, Altobelli E. Population-based study of incidence and clinical characteristics of rheumatic Fever in abruzzo, central Italy, 2000- 2009. J Pediatr 2012;160:832-6.
  • 10. Orün UA, Ceylan O, Bilici M, Karademir S, Ocal B, Senocak F. Acute rheumatic fever in the Central Anatolia Region of Turkey: a 30-year experience in a single center. Eur J Pediatr 2012;171:361-8.
  • 11. Ekici F, Kale Y, Kocabaş A. [Changing face of acute rheumatic fever: our clinical observations]. Anadolu Kardiyol Derg 2013;13:506-7.
  • 12. Anita K. M, Zaidi and Donald A. Goldman. Rheumatic fever in The Nelson Textbook of Pediatrics. Kliegman RM, Behrman RE, Jenson HB (eds). WB Saunders Company. 18 th edition. Philadelphia 2007:1140-45.
  • 13. Dajani A, Taubert K, Ferrieri P, Peter G, Shulman S. Treatment of acute streptococcal pharyngitis and prevention of rheumatic fever: a statement for health professionals. Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young, the American Heart Association. Pediatrics 1995;96:758-64.
  • 14. Shulman ST. Acute streptococcal pharyngitis in pediatric medicine: current issues in diagnosis and management. Paediatr Drugs 2003;5:13-23.
  • 15. Thatai D, Turi ZG. Current guidelines for the treatment of patients with rheumatic fever. Drugs 1999;57:545-55.
  • 16. Câmara EJ, Neubauer C, Câmara GF, Lopes AA. Mechanisms of mitral valvar insufficiency in children and adolescents with severe rheumatic heart disease: An echocardiographic study with clinical and epidemiological correlations. Cardiol Young 2004;14:527-32.
  • 17. Tompkins DG, Boxerbaum B, Liebman J. Long-term prognosis of rheumatic fever patients receiving regular intramuscular benzathine penicillin. Circulation 1972;45:543-51.
  • 18. Spagnuolo M, Pasternack B, Taranta A. Risk of rheumatic-fever recurrences after streptococcal infections. Prospective study of clinical and social factors. N Engl J Med 1971;285:641-7.
  • 19. Massell BF. Factors in the pathogenesis of rheumatic fever recurrences. J Maine Med Assoc 1962;53:88-93.
  • 20. Feinstein AR, Spagnuolo M. The clinical patterns of acute rheumatic fever: A reappraisal. Medicine 1962;41:279-305.
  • 21. Kaplan EL, Berrios X, Speth J, Siefferman T, Guzman B, Quesny F. Pharmacokinetics of benzathine penicillin G: Serum levels during the 28 days after intramuscular injection of 1,200,000 units. J Pediatr 1989;115:146-50.
  • 22. Oran B, Tastekin A, Karaaslan S, Bas L, Ayçiçek A, Ceri A, et al. Prophylactic efficiency of 3-weekly benzathine penicillin G in rheumatic fever. Indian J Pediatr 2000;67:163-7.
  • 23. Hodes RM. Recurrence of rheumatic fever after valve replacement. Cardiology 1989;76:465-8
  • 24. Nishimura RA, Carabello BA, Faxon DP, Freed MD, Lytle BW, O’Gara PT, et al. ACC/AHA 2008 Guideline update on valvular heart disease: focused update on infective endocarditis: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2008;52:676-85
  • 25. Monarch. Bicillin C-R (penicillin G benzathine and penicillin G procaine) injectable suspension disposable syringe 4 mL for deep IM injection only prescribing information. Bristol, TN; 2004 Jun.
  • 26. Farhadi A, Esmailzadeh M. Effect of local cold on intensity of pain due to Penicillin Benzathin intramuscular injection. International Journal of Medicine 2011;3:343-45.
  • 27. Schichor A, Bernstein B, Weinerman H, Fitzgerald J, Yordan E, Schechter N. Lidocaine as a diluent for ceftriaxone in the treatment of gonorrhea. Does it reduce the pain of the injection? Arch Pediatr Adolesc Med 1994;148:72-5.
  • 28. Christoph RA, Buchanan L, Begalla K, Schwartz S. Pain reduction in local anesthetic administration through pH buffering. Ann Emerg Med 1988;17:117-20.
  • 29. Amir J, Ginat S, Cohen YH, Marcus TE, Keller N, Varsano I. Lidocaine as a diluent for administration of benzathine penicillin G. Pediatr Infect Dis J 1998;17:890-3.
  • 30. Patel IH, Weinfeld RE, Konikoff J, Parsonnet M. Pharmacokinetics and tolerance of ceftriaxone in humans after single-dose intramuscular administration in water and lidocaine diluents. Antimicrob Agents Chemother 1982;21:957-62.
  • 31. Buhse M. Efficacy of EMLA cream to reduce fear and pain associated with interferon beta-1a injection in patients with multiple sclerosis. J Neurosci Nurs 2006;38:222-6.
  • 32. Taketomo CK, Hodding JH, Kraus DM. Pediatric dosage handbook. 12. Edition. Lexi Comp. 2005:986-93.
  • 33. Kök AN, Güler M, Çalangu S. Hekimlikte malpraktis. ANKEM Derg 2003;17:345-51.
  • 34. Joint Task Force on Practice Parameters. American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology; Joint Council of Allergy, Asthma and Immunology. Ann Allergy Asthma Immunol 2010;105:259-73.
  • 35. Kahn DA, Solensky R. Drug allergy. J Allergy Clin Immunol 2010;125:126-37.
  • 36. Karaman Ö, Babayiğit A, Ölmez D. Anafilaksi Nedenleri, Tanısı ve Tedavisi. Güncel Pediatri 2006;2:8-12.
  • 37. Pichler WJ, Adam J, Daubner B, Gentinetta T, Keller M, Yerly D. Drug hypersensitivity reactions: pathomechanism and clinical symptoms. Med Clin North Am 2010;94:645-64.
  • 38. Adkinson FN, Bochner SB, Busse WW, Holgate TS, Remanske FR, Simons REF. Middleton’s Allergy principles and practice. 7 th ed. St.Louis: Mosby Elsevier, 2009:1205-26.
  • 39. Segal AR, Doherty KM, Leggott J, Zlotoff B. Cutaneous reactions to drugs in children. Pediatrics 2007;120:1082-96.
  • 40. Romano A, Torres MJ, Castells M, Sanz ML, Blanca M. Diagnosis and management of drug hypersensitivity reactions. J Allergy Clin Immunol 2011;127:67-73.
  • 41. Schnyder B. Approach to the patient with drug allergy. Immunol Allergy Clin North Am 2009;29:405-18.
  • 42. Fontaine C, Mayorga C, Bousquet PJ. Relevance of the determination of serum-specific IgE antibodies in the diagnosis of immediate beta-lactam allergy. Allergy 2007;62:47-52.
  • 43. Aberer W, Birger K. Provocation test in drug hypersensitivity. Immunol Allergy Clin North Am 2009;29:567-84.
  • 44. Romano A, Gaeta F, Valluzzi RL, Caruso C, Rumi G, Bousquet PJ. IgE-mediated hypersensitivity to cephalosporins: cross￾reactivity and tolerability of penicillins, monobactams, and carbapenems. J Allergy Clin Immunol 2010;126:994-9.
  • 45. Antico A, Pagani M, Compalati E, Vescovi PP, Passalacqua G. Risk Assessment of Immediate Systemic Reactions from Skin Tests with β-Lactam Antibiotics. Int Arch Allergy Immunol 2011;156:427-33.
  • 46. Leung M Y D, Sampson H, Geha R. Pediatric Allergy, 2nd ed. Saunders Elsevier, 2010:616-48.
  • 47. Simons FE, Ardusso LR, Dimov V, Ebisawa M, El-Gamal YM, Lockey RF, et al. World allergy organization anaphylaxis guidelines: 2013 update of the evidence base. Int Arch Allergy Immunol 2013;162:193-204.
  • 48. Sampson HA, Munoz-Furlong A, Campbell RL, Adkinson NF Jr, Bock SA, Branum A, et al. Second symposium on the definition and management of anaphylaxis: summary report - Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network Symposium. J Allergy Clin Immunol 2006;117:391-7.
  • 49. Vadas P, Perelman B, Liss G. Platelet-activating factor, histamine, and tryptase levels in human anaphylaxis. J Allergy Clin Immunol 2013;131:144-49.
  • 50. Soar J, Deakin CD, Nolan JP, Abbas G, Alfonzo A, Handley AJ, et al. European Resuscitation Council guidelines for resuscitation 2005, Section 7. Cardiac arrest in special circumstances. Resuscitation 2005;6751:135-70.
Toplam 50 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Research Article
Yazarlar

Murat Çiftel Bu kişi benim

Ayşe Süleyman Bu kişi benim

Halil Ertuğ Bu kişi benim

Yayımlanma Tarihi 1 Haziran 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 13 Sayı: 1

Kaynak Göster

APA Çiftel, M., Süleyman, A., & Ertuğ, H. (2015). Akut Romatizmal Ateşli Çocuklarda Penisilin Tedavisi: Yan Etkileri, Malpraktis ve Anaflaktik Reaksiyon. Güncel Pediatri, 13(1), 31-39. https://doi.org/10.4274/jcp.46330
AMA Çiftel M, Süleyman A, Ertuğ H. Akut Romatizmal Ateşli Çocuklarda Penisilin Tedavisi: Yan Etkileri, Malpraktis ve Anaflaktik Reaksiyon. Güncel Pediatri. Haziran 2015;13(1):31-39. doi:10.4274/jcp.46330
Chicago Çiftel, Murat, Ayşe Süleyman, ve Halil Ertuğ. “Akut Romatizmal Ateşli Çocuklarda Penisilin Tedavisi: Yan Etkileri, Malpraktis Ve Anaflaktik Reaksiyon”. Güncel Pediatri 13, sy. 1 (Haziran 2015): 31-39. https://doi.org/10.4274/jcp.46330.
EndNote Çiftel M, Süleyman A, Ertuğ H (01 Haziran 2015) Akut Romatizmal Ateşli Çocuklarda Penisilin Tedavisi: Yan Etkileri, Malpraktis ve Anaflaktik Reaksiyon. Güncel Pediatri 13 1 31–39.
IEEE M. Çiftel, A. Süleyman, ve H. Ertuğ, “Akut Romatizmal Ateşli Çocuklarda Penisilin Tedavisi: Yan Etkileri, Malpraktis ve Anaflaktik Reaksiyon”, Güncel Pediatri, c. 13, sy. 1, ss. 31–39, 2015, doi: 10.4274/jcp.46330.
ISNAD Çiftel, Murat vd. “Akut Romatizmal Ateşli Çocuklarda Penisilin Tedavisi: Yan Etkileri, Malpraktis Ve Anaflaktik Reaksiyon”. Güncel Pediatri 13/1 (Haziran 2015), 31-39. https://doi.org/10.4274/jcp.46330.
JAMA Çiftel M, Süleyman A, Ertuğ H. Akut Romatizmal Ateşli Çocuklarda Penisilin Tedavisi: Yan Etkileri, Malpraktis ve Anaflaktik Reaksiyon. Güncel Pediatri. 2015;13:31–39.
MLA Çiftel, Murat vd. “Akut Romatizmal Ateşli Çocuklarda Penisilin Tedavisi: Yan Etkileri, Malpraktis Ve Anaflaktik Reaksiyon”. Güncel Pediatri, c. 13, sy. 1, 2015, ss. 31-39, doi:10.4274/jcp.46330.
Vancouver Çiftel M, Süleyman A, Ertuğ H. Akut Romatizmal Ateşli Çocuklarda Penisilin Tedavisi: Yan Etkileri, Malpraktis ve Anaflaktik Reaksiyon. Güncel Pediatri. 2015;13(1):31-9.