Incidence of and risk factors for side effects associated with antibiotic treatment for pneumonia

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy Pub Date : 2025-08-08 DOI:10.1016/j.jiac.2025.102789

Nobuyoshi Hamao , Isao Ito , Satoshi Konishi , Naoya Tanabe , Issei Oi , Yoshiro Yasutomo , Seizo Kadowaki , Toyohiro Hirai

{"title":"Incidence of and risk factors for side effects associated with antibiotic treatment for pneumonia","authors":"Nobuyoshi Hamao , Isao Ito , Satoshi Konishi , Naoya Tanabe , Issei Oi , Yoshiro Yasutomo , Seizo Kadowaki , Toyohiro Hirai","doi":"10.1016/j.jiac.2025.102789","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the incidence of side effects associated with beta-lactam antibiotics commonly used in pneumonia treatment and the risk factors for each side effect.</div></div><div><h3>Methods</h3><div>Patients with community-acquired or healthcare-associated pneumonia were prospectively enrolled between June 2002 and December 2012. Patients were administered with beta-lactam antibiotics in the treatment of pneumonia. All side effects observed during the antibiotic treatment were recorded. Multivariate analysis was performed to identify independent risk factors for each side effect.</div></div><div><h3>Results</h3><div>A total of 1162 patients were enrolled in this study. The antibiotics used for treatment were ampicillin/sulbactam in 362, piperacillin/tazobactam in 111, cefotiam in 89, ceftriaxone in 140, cefepime in 130, imipenem/cilastatin in 110, meropenem in 97, and others in 123 cases. Diarrhea, elevated liver enzyme levels, and skin rash were observed in 174 (15.0 %), 52 (4.5 %), and 28 (2.4 %) patients, respectively. In multivariate analysis, female sex (p < 0.05) and use of either piperacillin/tazobactam (p < 0.05), cefepime (p < 0.05), or imipenem/cilastatin (p < 0.05) were significantly associated with diarrhea. Use of cefotiam (p < 0.05) or meropenem (p < 0.05) were significantly associated with elevated liver enzyme levels. No significant risk factors were found for skin rashes.</div></div><div><h3>Conclusion</h3><div>Broad-spectrum antibiotics tended to cause diarrhea more frequently. The use of cefotiam and meropenem was associated with increased liver enzyme levels.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 9","pages":"Article 102789"},"PeriodicalIF":1.5000,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Infection and Chemotherapy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1341321X25001862","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

To determine the incidence of side effects associated with beta-lactam antibiotics commonly used in pneumonia treatment and the risk factors for each side effect.

Methods

Patients with community-acquired or healthcare-associated pneumonia were prospectively enrolled between June 2002 and December 2012. Patients were administered with beta-lactam antibiotics in the treatment of pneumonia. All side effects observed during the antibiotic treatment were recorded. Multivariate analysis was performed to identify independent risk factors for each side effect.

Results

A total of 1162 patients were enrolled in this study. The antibiotics used for treatment were ampicillin/sulbactam in 362, piperacillin/tazobactam in 111, cefotiam in 89, ceftriaxone in 140, cefepime in 130, imipenem/cilastatin in 110, meropenem in 97, and others in 123 cases. Diarrhea, elevated liver enzyme levels, and skin rash were observed in 174 (15.0 %), 52 (4.5 %), and 28 (2.4 %) patients, respectively. In multivariate analysis, female sex (p < 0.05) and use of either piperacillin/tazobactam (p < 0.05), cefepime (p < 0.05), or imipenem/cilastatin (p < 0.05) were significantly associated with diarrhea. Use of cefotiam (p < 0.05) or meropenem (p < 0.05) were significantly associated with elevated liver enzyme levels. No significant risk factors were found for skin rashes.

Conclusion

Broad-spectrum antibiotics tended to cause diarrhea more frequently. The use of cefotiam and meropenem was associated with increased liver enzyme levels.

查看原文本刊更多论文

肺炎抗生素治疗相关副作用的发生率和危险因素

目的了解肺炎常用β -内酰胺类抗生素的不良反应发生率及各不良反应的危险因素。方法前瞻性纳入2002年6月至2012年12月期间社区获得性或卫生保健相关肺炎患者。患者在治疗肺炎时给予β -内酰胺类抗生素。记录抗生素治疗期间观察到的所有副作用。进行多变量分析以确定每种副作用的独立危险因素。结果共纳入1162例患者。应用抗生素为氨苄青霉素/舒巴坦362例，哌拉西林/他唑巴坦111例，头孢替安89例，头孢曲松140例，头孢吡肟130例，亚胺培南/西司他汀110例，美罗培南97例，其他123例。腹泻、肝酶水平升高和皮疹分别在174例（15.0%）、52例（4.5%）和28例（2.4%）患者中出现。在多变量分析中，女性(p <；0.05)和哌拉西林/他唑巴坦的使用(p <；0.05)，头孢吡肟(p <；0.05)，或亚胺培南/西司他汀(p <；0.05)与腹泻显著相关。使用头孢替安(p <；0.05)或美罗培南(p <；0.05)与肝酶水平升高显著相关。没有发现明显的皮疹危险因素。结论广谱抗生素更易引起腹泻。头孢替安和美罗培南的使用与肝酶水平升高有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Infection and Chemotherapy INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY

CiteScore

4.10

自引率

4.50%

发文量

303

审稿时长

47 days

期刊介绍： The Journal of Infection and Chemotherapy (JIC) — official journal of the Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases — welcomes original papers, laboratory or clinical, as well as case reports, notes, committee reports, surveillance and guidelines from all parts of the world on all aspects of chemotherapy, covering the pathogenesis, diagnosis, treatment, and control of infection, including treatment with anticancer drugs. Experimental studies on animal models and pharmacokinetics, and reports on epidemiology and clinical trials are particularly welcome.