Streptokinase and premedication strategies: Incidence of type I hypersensitivity reactions associated with streptokinase in clinical practice

Abstract

Type I hypersensitivity reactions are observed following the administration of streptokinase, resulting in poor outcomes and increased mortality. Premedication serves as a strategy to prevent these reactions in clinical practice. This study aimed to determine the incidence of type I hypersensitivity reactions associated with patients who received streptokinase and premedication. This retrospective descriptive study collected data from the electronic medical records of Nakhon Pathom Hospital covering the period from January 1, 2019 to July 31, 2021. Seventy-four participants were identified. The incidence of type I hypersensitivity reactions was 459 cases/1,000 patients. The most common type I hypersensitivity reaction was hypotension, followed by anaphylactic shock and respiratory complications. All patients with hypotension fully recovered with appropriate management; however, all patients experiencing anaphylactic shock did not survive. An inferior wall infarction was significantly associated with these reactions. In conclusion, type I hypersensitivity reactions occurred despite the administration of premedication in patients who received streptokinase. Healthcare professionals should closely monitor and carefully manage these cases for desirable clinical outcomes.