title: Prophylactic antibiotic administration induced bronchospasm as increased airway pressure during general anesthesia.
abstract: BACKGROUND
  Anaphylactic reaction induced bronchospasm as wheezing and severe elevation of airway pressure was observed in a succession of patients during general anesthesia at our institute in November 2007. The aim of this survey was to investigate the suspected causes and risk factors of these anaphylactic reactions and the degree of correlation.
  
  
  METHODS
  All patients who received general anesthesia between November 1 and November 10, 2007 were enrolled. Underlying diseases, substances including intravenous and inhalational anesthetics, antibiotics, and the degree of increase in airway pressure were recorded. Enrolled patients were divided into a significant-airway-pressure-elevation group (Group P) and a no-airway-pressure-elevation group (Group N).
  
  
  RESULTS
  A new brand of cephalexin (Roles) used as a prophylactic antibiotic was identified as the most likely causative substance of this succession of suspected anaphylactic reactions (28 in 185 patients, 15.14%), and rapid administration was a contributor to these anaphylactic reactions.
  
  
  CONCLUSIONS
  In this study, we found that rapid administration of Roles was the main cause of suspected anaphylactic reaction presenting as bronchospasm with severe elevated airway pressure. Using Roles as the prophylactic antibiotic is not recommended in patients receiving general anesthesia.
authors.affiliation: Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
authors.forename: Yi-Min
authors.initials: YM
authors.lastname: Kuo
authors.forename: Chien-Kun
authors.initials: CK
authors.lastname: Ting
authors.forename: Yu-Chieh
authors.initials: YC
authors.lastname: Wang
authors.forename: Wen-Kuei
authors.initials: WK
authors.lastname: Chang
authors.forename: Hsin-Lun
authors.initials: HL
authors.lastname: Wu
authors.forename: Kwok-Hon
authors.initials: KH
authors.lastname: Chan
authors.forename: Pin-Tarng
authors.initials: PT
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000707:Anaphylaxis / Q000139:chemically induced*; D000768:Anesthesia, General; D019072:Antibiotic Prophylaxis / Q000009:adverse effects*; D001986:Bronchial Spasm / Q000139:chemically induced*; D002506:Cephalexin / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D012189:Retrospective Studies
chemical_list: D002506:Cephalexin