关键词: 药源性双硫仑样反应, 医疗损害责任纠纷, 中国裁判文书网

Abstract: Objective To analyze the regularity and characteristics of the medical damage liability dispute with drug-induced disulfiram-like reaction,to avoid the risk of medication and provide reference for clinical rational drug use. Methods China Judgements Online had been searched using the keywords of “disulfiram” from inception to March 25,2025. The evaluation table database was established with the excel table to conduct statistical analysis on the basic information of judgements,drug association,clinical performance,outcome of disease and the compensation. Results A total of 81 cases of judgements documents were retrieved,and 18 cases were enrolled. There were 3 tertiary hospitals, 5 second-class hospitals, 7 health-centers, 2 private hospitals,1 clinic among the medical establishments. Fifteen cases were male and 3 cases were female. The drugs suspected causing disulfiram-like reaction were cefoperazone,cefuroxime,tinidazole,cefotaxime,metronidazole,levofloxacin,ceftriaxone,cefotiam,cefminox. The interval between drinking and medication was usually 1-3 days. The symptoms were as follows：dyspnea/respiratory arrest,coma/loss of consciousness/shock,cyanosis /purple nails,convulsion/trembling,sweatiness,inability to speak/lack of clarity,etc. Fifteen cases ended in death,1 was neurosis,1 was first-degree disability (vegetative state),1 was secondary disability (limb dysfunction after hypoxic encephalopathy). The identification of 7 cases of death was affected by the lack of autopsy. One case was settled and the outcome of the third trial was not announced in another case. The remaining 16 medical institutions took 10%-70% of the medical compensation liability,with the compensation amount ranging from 43 092. 4 yuan to 1 615 354 yuan. The main faults of the medical institutions were undetailed drinking history,irregular medication,breaches of duty of reasonable care,failure to fulfill the obligation of informed notification,etc. Conclusions Drug-induced disulfiram-like reaction has the characteristics of graveness of harm and rapid progress. Primary medical institutions need to improve their identification and disposal capacity urgently. Attention should be paid to collecting and recording of drinking history. Antibiotics should be used in a reasonable and compliant manner. Obligation of high attention to patients,information and other obligations should be fulfilled. Hospital pharmacy staff should ensure drug use safety through participating in drug education actively.

Key words: drug-induced disulfiram-like reaction, medical damage liability dispute, China Judgements Online