Varied incidence of immediate adverse reactions to low-osmolar non-ionic iodide radiocontrast media used in computed tomography.
BACKGROUND
Low-osmolar non-ionic radiocontrast media (RCMs) are commonly used throughout hospitals. However, the incidence of immediate adverse drug reactions (ADRs) to various low-osmolar non-ionic RCMs is not well studied. We compared the incidence of immediate ADRs among different low-osmolar non-ionic RCMs used in computed tomography (CT).


METHODS
Severance Hospital has collected data for adverse reactions occurring in-hospital using an internally developed system. Using this data, we reviewed 1969 immediate ADRs from 286 087 RCM-contrasted CT examinations of 142 099 patients and compared the immediate ADRs of iobitridol, iohexol, iopamidol, and iopromide. We analysed the incidence of immediate ADRs to different RCMs, as well as the effect of single or multiple CT examinations per day.


RESULTS
Iopromide showed the highest incidence of immediate ADRs (1.03%) and was followed by iopamidol (0.67%), iohexol (0.64%), and iobitridol (0.34%). In cases of anaphylaxis, iopromide also showed the highest incidence (0.041%), followed by iopamidol (0.023%), iohexol (0.018%), and iobitridol (0.012%). Risk of immediate ADR due to multiple CT examinations (1.19%) was significantly higher than the risk due to a single CT examination (0.63%). Risk of anaphylaxis was also higher for multiple CT examinations (0.052%) than for a single CT examination (0.020%).


CONCLUSIONS AND CLINICAL RELEVANCE
The incidence of immediate ADRs varied according to the low-osmolar non-ionic RCM used. Iopromide-induced immediate ADRs were more frequent, while iobitridol was associated with fewer immediate ADRs than other RCMs. Multiple CT examinations per day resulted in a higher incidence of immediate ADRs and anaphylaxis than a single CT examination. Clinicians should consider these risk differences of immediate ADRs when prescribing contrasted CT examinations.
['Kim|S R|SR|', 'Lee|J H|JH|', 'Park|K H|KH|', 'Park|H J|HJ|', 'Park|J W|JW|']
D000293:Adolescent D000328:Adult D000368:Aged D000707:Anaphylaxis D016022:Case-Control Studies D002648:Child D002675:Child, Preschool D003287:Contrast Media D004342:Drug Hypersensitivity D005260:Female D006801:Humans D015994:Incidence D007223:Infant D007231:Infant, Newborn D007454:Iodides D008297:Male D008875:Middle Aged D016017:Odds Ratio D012306:Risk D014057:Tomography, X-Ray Computed D055815:Young Adult
non-ionic radiocontrast media immediate adverse drug reaction anaphylaxis