title: Adverse events of acupuncture: a systematic review of case reports.
abstract: Acupuncture, moxibustion, and cupping, important in traditional Eastern medicine, are increasingly used in the West. Their widening acceptance demands continual safety assessment. This review, a sequel to one our team published 10 years ago, is an evaluation of the frequency and severity of adverse events (AEs) reported for acupuncture, moxibustion, and cupping between 2000 and 2011. Relevant English-language reports in six databases were identified and assessed by two reviewers. During this 12-year period, 117 reports of 308 AEs from 25 countries and regions were associated with acupuncture (294 cases), moxibustion (4 cases), or cupping (10 cases). Country of occurrence, patient's sex and age, and outcome were extracted. Infections, mycobacterial, staphylococcal, and others, were the main complication of acupuncture. In the previous review, we found the main source of infection to be hepatitis, caused by reusable needles. In this review, we found the majority of infections to be bacterial, caused by skin contact at acupoint sites; we found no cases of hepatitis. Although the route of infection had changed, infections were still the major complication of acupuncture. Clearly, guidelines such as Clean Needle Technique must be followed in order to minimize acupuncture AEs.
authors.affiliation: Acupuncture Department, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai 200071, China ; Center for Integrative Medicine, School of Medicine, University of Maryland, East Hall, 520 W. Lombard Street, Baltimore, MD 21201, USA.
authors.forename: Shifen
authors.initials: S
authors.lastname: Xu
authors.forename: Lizhen
authors.initials: L
authors.lastname: Wang
authors.forename: Emily
authors.initials: E
authors.lastname: Cooper
authors.forename: Ming
authors.initials: M
authors.lastname: Zhang
authors.forename: Eric
authors.initials: E
authors.lastname: Manheimer
authors.forename: Brian
authors.initials: B
authors.lastname: Berman
authors.forename: Xueyong
authors.initials: X
authors.lastname: Shen
authors.forename: Lixing
authors.initials: L
authors.lastname: Lao