Prevalence of Drug Fever among Cases of Nosocomial Fever: A Systematic Review and Meta-analysis
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- Someko Hidehiro
- Department of General Internal Medicine, Asahi General Hospital, Japan Scientific Research WorkS Peer Support Group (SRWS-PSG), Japan
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- Okazaki Yuuji
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Japan Department of Emergency Medicine, Hiroshima City Hiroshima Citizens Hospital, Japan
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- Kuniyoshi Yasutaka
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Japan Department of Pediatrics, Tsugaruhoken Medical COOP Kensei Hospital, Japan
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- Yoshida Akira
- Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Japan
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- Baba Keisuke
- Department of Medical Oncology and General Medicine, IMSUT Hospital, Institute of Medical Science, University of Tokyo, Japan
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- Ijiri Atsuhiro
- Department of Emergency Medicine, School of Medicine, National Defense Medical College, Japan
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- Tsujimoto Yasushi
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Japan Oku Medical Clinic, Japan Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto University, Japan
抄録
<p>Objective Drug fever is defined as a fever that temporally coincides with the start of a culprit drug and disappears after discontinuation of the drug. It is a common cause of nosocomial fever, which refers to a fever that develops beyond the first 48 h after hospital admission. However, the exact prevalence of drug fever among cases of nosocomial fever is unclear, as is the variation in prevalence depending on the clinical setting and most common causative drugs. </p><p>Methods PubMed MEDLINE, Dialog EMBASE, Cochrane Central Register of Controlled Trials, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov were systematically searched. Studies that reported the prevalence of drug fever in patients with nosocomial fever were included. Two of the four reviewers conducted independent assessments of the inclusion, data extraction, and quality. Pooled adjusted odds ratios were generated using a random-effects model and presented with 95% confidence intervals (CIs). </p><p>Results Fifteen meta-analysis from 15 studies were included. Ten studies did not report the definition of drug fever or excluded febrile patients who were admitted to the hospital within 24-48 h. The pooled prevalence of drug fever among cases of nosocomial fever was 3.0% (95% CI, 0.6-6.8%), which was largely consistent across the settings, except for at oriental medicine hospital. Only four studies reported the causative agents, and antibiotics were the most frequently reported. </p><p>Conclusions The prevalence of drug fever is low in patients with nosocomial fever. Clinicians should recognize that drug fever is a diagnosis of exclusion, even in cases of nosocomial fever. </p>
収録刊行物
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- Internal Medicine
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Internal Medicine 63 (8), 1067-1074, 2024-04-15
一般社団法人 日本内科学会