International Journal of Antimicrobial Agents最新文献

{"title":"Ceftazidime-avibactam for the treatment of infections caused by carbapenem-resistant Gram-negative pathogens in Chinese patients: A phase IV, multi-center, open‑label study.","authors":"Jinyi Yuan, Huaxue Wang, Xiaoju Zhang, Fei Xie, Panpan Wang, Hua Zhu, Paurus Irani, Junchao Lu, Fanglei Liu, Yuting Mu, Haihui Huang, Yingyuan Zhang","doi":"10.1016/j.ijantimicag.2026.108030","DOIUrl":"https://doi.org/10.1016/j.ijantimicag.2026.108030","url":null,"abstract":"<p><strong>Background: </strong>Ceftazidime-avibactam is approved in China for complicated intra‑abdominal infections (cIAIs), hospital-acquired/ventilator-associated pneumonia (HAP/VAP), and other infections with limited treatment options due to aerobic Gram‑negative bacteria. This post-approval phase IV study assessed the effectiveness and safety of ceftazidime-avibactam in Chinese adults with carbapenem-resistant Gram-negative bacterial infections.</p><p><strong>Methods: </strong>In this prospective, multi-center, open-label, active-controlled study in China, patients with bloodstream infections, cIAIs, complicated urinary tract infections, and HAP/VAP were randomized to ceftazidime-avibactam or best available treatment (BAT). The primary efficacy endpoint was clinical response at the test-of-cure (TOC) visit in the microbiologically modified intention-to-treat (mMITT) analysis set. Endpoint comparisons were descriptive with nominal P-values.</p><p><strong>Results: </strong>Overall, 59 patients received ceftazidime-avibactam (n=30) or BAT (n=29), mostly for primary HAP/VAP (>70%, both arms). The most common baseline isolate was Klebsiella pneumoniae (ceftazidime-avibactam, 66.7% [16/24]; BAT, 84.6% [22/26]). In the mMITT set (n=27, each arm), clinical cure (95% confidence interval) at TOC was higher for ceftazidime-avibactam (59.3% [40.6-76.1]) than BAT (25.9% [12.4-44.3]). Microbiological response at TOC favored ceftazidime‑avibactam (59.3%) over BAT (25.9%). All-cause mortality at day 28 was similar for ceftazidime-avibactam (4/30 [13.3%]) and BAT (4/29 [13.8%]; intention‑to‑treat analysis set). Adverse events (AEs) in patients treated with ceftazidime‑avibactam versus BAT included: all-causality AEs, 24 (80.0%) vs. 26 (89.7%); serious AEs, 7 (23.3%) vs. 11 (37.9%); severe AEs, 6 (20.0%) vs. 11 (37.9%); and AEs leading to death, 5 (16.7%) vs. 7 (24.1%).</p><p><strong>Conclusions: </strong>These results support the effectiveness and safety of ceftazidime‑avibactam in Chinese patients with carbapenem-resistant infections and limited treatment options.</p><p><strong>Clinicaltrials: </strong></p><p><strong>Gov identifier: </strong>NCT04882085.</p>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":" ","pages":"108030"},"PeriodicalIF":5.0,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disk diffusion and ETEST (gradient diffusion) may produce false susceptible results for Pseudomonas aeruginosa from cystic fibrosis patients due to inducible colistin tolerance.","authors":"Niels Høiby, Hengzhuang Wang, Kaj-Åge Henneberg, Tim Tolker-Nielsen, Doaa Higazy, Claus Moser, Ulla Rydahl Johansen, Oana Ciofu","doi":"10.1016/j.ijantimicag.2026.108022","DOIUrl":"https://doi.org/10.1016/j.ijantimicag.2026.108022","url":null,"abstract":"<p><p>Disk diffusion and ETEST may produce false susceptibility to colistin of P. aeruginosa. Delayed regrowth in the inhibition zone may be observed after 24h incubation in P. aeruginosa from cystic fibrosis patients (CF). Early reading may therefore misclassify P. aeruginosa as colistin susceptible. Our hypothesis is, that the delayed growth is due to inducible tolerance caused by changed LPS and this was tested by employing P. aeruginosa PAO1 and 10 Danish CF isolates for broth micro dilution (BMD), disk diffusion, ETEST, calculation of time-dependent concentration of colistin in blood agar, minimum biofilm eradication concentration, inducible tolerance of P. aeruginosa in liquid media containing colistin, gene expression analysis and whole genome sequencing. Population analysis was done to detect heteroresistance. PAO1 and 8 CF isolates gave same categorical susceptibility by BMD and ETEST. Two CF isolates were colistin resistant by ETEST but susceptible by BMD (major error). PAO1 and one colistin susceptible CF isolate did not show delayed growth in the inhibition zone although inducible tolerance of PAO1 was observed in liquid media since the diffusing colistin killed the bacteria in the inhibition zone. The other CF isolates showed delayed regrowth in the inhibition zone, and the colistin regrowth-ETEST-MIC was ≥64µg/ml. Five of 6 CF isolates had inducible tolerance in liquid media containing colistin whereas the sixth was completely resistant. They had mutations in various genes involved with inducible tolerance. In conclusion, inducible tolerance combined with mutations in the corresponding genes is the reason for the delayed growth and false susceptibility to colistin.</p>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":" ","pages":"108022"},"PeriodicalIF":5.0,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomedical Applications of Antimicrobial Peptides: Multifunctional Mechanisms, Engineering Strategies, and Therapeutic Development.","authors":"Xinyi Zhang, Junyi Deng, Yanan Cao, Xinya Feng, Yunlong Liu, Xiuping Fu, Mengtian Ren","doi":"10.1016/j.ijantimicag.2026.108027","DOIUrl":"https://doi.org/10.1016/j.ijantimicag.2026.108027","url":null,"abstract":"<p><p>Antimicrobial peptides (AMPs) are small, multifunctional molecules generated by the innate immune systems of various organisms. AMPs possess broad-spectrum antimicrobial activity and operate through mechanisms that target microbial membranes, cell walls, and intracellular processes. These peptides are viewed as promising solutions to the growing problem of antibiotic resistance. This review provides a comprehensive overview of the various sources, structural characteristics, and primary antimicrobial mechanisms, which include disrupting microbial membranes and cell walls, interfering with intracellular metabolic processes, and modulating the immune response. It also explores possible mechanisms by which bacteria might develop resistance to these peptides. Building on this knowledge, the review highlights recent approaches to enhance AMP design, including the creation of self-assembling nanostructures, the use of combination therapies, and targeted modifications to improve stability and specificity. AMPs have wide-ranging potential applications in biomedical fields like drug delivery systems, wound dressings, and smart materials. Nonetheless, their clinical application faces obstacles such as limited stability, potential toxicity, and high manufacturing costs. With progress in Artificial Intelligence (AI)-driven design, nanotechnology, and synthetic biology, AMPs are expected to overcome these challenges and become vital components of future anti-infective treatments.</p>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":" ","pages":"108027"},"PeriodicalIF":5.0,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Convergence of carbapenem resistance and hypervirulence in Klebsiella pneumoniae in Europe: a systematic review.","authors":"Axelle Vasseur, Marie Fave, Sarah Ronsin, Thierry Naas, Laurent Dortet, Rémy A Bonnin, Agnès B Jousset","doi":"10.1016/j.ijantimicag.2026.108028","DOIUrl":"https://doi.org/10.1016/j.ijantimicag.2026.108028","url":null,"abstract":"<p><p>The convergence of hypervirulence and carbapenem resistance in Klebsiella pneumoniae (hv-CRKP) is an emerging public health threat. Although extensively reported in Asia, these strains are increasingly identified in Europe, where their epidemiology and underlying convergence mechanisms remain insufficiently characterized. We aimed to describe the circulation of hv-CRKP in Europe, their molecular characteristics, and the main mechanisms underlying the convergence of resistance and hypervirulence. We performed a systematic literature review using PubMed and identified studies published up to 31 October 2024 reporting hv-CRKP isolates from human samples in Europe. Hypervirulence was defined using genomic criteria (major virulence genes or Kleborate score ≥3) and/or a highly suggestive clinical presentation. A total of 419 isolates from 30 studies were analyzed. hv-CRKP isolates were identified in 14 European countries, with major epidemic clusters reported in Italy and Germany. In contrast to the Asian epidemiology dominated by ST11-KPC-producing clones, the European landscape showed marked clonal diversity, mainly involving ST147, ST23, ST307 and ST395. NDM was the predominant carbapenemase type (75.4%, 316/419) alone or in combination with other carbapenemases, followed by OXA-48-like enzymes (37.7%, 158/419). Hybrid plasmids derived from pNDM-MAR-like backbones emerged as key drivers of convergence by enabling co-transfer of virulence and resistance determinants. hv-CRKP are increasingly reported in Europe, mainly through multidrug-resistant hospital-adapted clones acquiring virulence determinants. Their epidemic potential, combined with imperfect genotype-phenotype correlation, complicates identification and challenges historical definitions of hypervirulence. Surveillance strategies should move beyond resistance alone and integrate virulence markers to enable earlier detection and prevent nosocomial spread.</p>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":" ","pages":"108028"},"PeriodicalIF":5.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OmpK36 Alterations Are Associated with Reduced Imipenem/Relebactam Susceptibility in KPC-2-Producing Klebsiella pneumoniae, with Dose-Dependent Restoration at Higher Relebactam Concentrations.","authors":"Jin Yang Baek, Yun Young Cho, Jinyoung Yang, Kyungmin Huh, Sun Young Cho, Cheol-In Kang, Doo Ryeon Chung, Kyong Ran Peck, Hee Jae Huh, Tae Yeul Kim, Jae-Hoon Ko","doi":"10.1016/j.ijantimicag.2026.108029","DOIUrl":"https://doi.org/10.1016/j.ijantimicag.2026.108029","url":null,"abstract":"<p><strong>Introduction: </strong>Resistance to novel β-lactam/β-lactamase inhibitor (BL/BLI) combinations among KPC-2-producing Klebsiella pneumoniae poses a therapeutic challenge. Although resistance driven by KPC-2 mutations following drug exposure has been described, increased MICs are frequently observed in the absence of KPC mutations.</p><p><strong>Methods: </strong>We performed whole-genome sequencing and quantitative transcript analysis of 13 KPC-2-producing K. pneumoniae isolates that were non-susceptible to novel BL/BLI combinations, primarily imipenem/relebactam, despite being collected prior to their clinical introduction.</p><p><strong>Results: </strong>The 13 isolates were non-susceptible to ceftazidime/avibactam (7.7%), imipenem/relebactam (92.3%), or meropenem/vaborbactam (15.4%), and demonstrated dose-dependent reductions in BL MICs with increasing BLI concentrations. Whole-genome sequencing identified truncating ompK36 mutations in 8 isolates (61.5%) and non-truncating variants, including missense substitutions and/or in-frame indels, in 3 isolates (23.1%). Transcript analysis showed ≥2-fold reduced ompK36 expression in 6 isolates with ompK36 mutations, including four with marked (≥3-fold) and one with profound (≥10-fold) suppression. The only isolate that remained resistant to imipenem/relebactam despite a four-fold increase in relebactam concentration exhibited profound suppression of ompK35 and ompK36 and harbored concurrent truncating mutations in both genes. In contrast, blaKPC-2 expression varied by <2-fold across all isolates.</p><p><strong>Conclusions: </strong>Loss or reduced expression of ompK36 was associated with reduced imipenem/relebactam susceptibility and dose-dependent responses to increasing relebactam concentrations, without evidence of β-lactamase overexpression or KPC-2 mutation.</p>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":" ","pages":"108029"},"PeriodicalIF":5.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Comment on 'Burden and global distribution of antimicrobial resistance in nonbloodstream infections among adults with cirrhosis: A systematic review and proportional meta-analysis'.","authors":"Ellis K Paintsil, Cansu Ozdemir, Tuhin Paul, Kasope Egoh, Joseph J Wanford, Denise Dekker, Debbie L Shawcross","doi":"10.1016/j.ijantimicag.2026.108019","DOIUrl":"10.1016/j.ijantimicag.2026.108019","url":null,"abstract":"","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":" ","pages":"108019"},"PeriodicalIF":5.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined antibacterial activity of imipenem-funobactam with different antibiotics against carbapenem-resistant gram-negative bacteria in China.","authors":"Dandan Yin, Jinye Du, Yan Guo, Renru Han, Shi Wu, Fupin Hu","doi":"10.1016/j.ijantimicag.2026.108025","DOIUrl":"https://doi.org/10.1016/j.ijantimicag.2026.108025","url":null,"abstract":"<p><strong>Objective: </strong>Funobactam (FNB), a novel β-lactamase inhibitor, has shown potential capability to restore the activity of β-lactam antibiotics. However, the antibacterial activity of imipenem-funobactam (IPM-FNB) combined with other antibiotics remains insufficiently studied against carbapenem-resistant gram-negative bacteria (CR-GNB).</p><p><strong>Methods: </strong>A total of 199 clinical CR-GNB isolates, including carbapenem-resistant Escherichia coli (CREC, 32 isolates), carbapenem-resistant Klebsiella pneumoniae (CRKP, 47 isolates), carbapenem-resistant Acinetobacter baumannii (CRAB, 58 isolates), and carbapenem-resistant Pseudomonas aeruginosa (CRPA, 62 isolates), were collected across China from 26 medical centers. Antimicrobial susceptibility of IPM-FNB combined with aztreonam, ceftazidime, sulbactam, amikacin, ciprofloxacin, polymyxin B, or tigecycline was determined by broth microdilution with checkerboard assays, and the fractional inhibitory concentration index (FIC) was calculated. Time-kill assays were performed for partial isolates selected according to the FIC.</p><p><strong>Results: </strong>Against CREC and CRKP, IPM-FNB combined with aztreonam mainly exhibited synergistic effects (75.0% and 70.0%, respectively), with bactericidal activity in representative isolates against New Delhi metallo-β-lactamase (NDM)- and Klebsiella pneumoniae carbapenemase (KPC)-2-producing isolates. Against CRAB, IPM-FNB combined with sulbactam demonstrated the highest synergistic effect (68.8%) and showed rapid, sustained bactericidal activity in time-kill assays. Against CRPA, most combinations showed additive effects, although IPM-FNB plus aztreonam achieved synergistic bactericidal activity in the tested isolate.</p><p><strong>Conclusions: </strong>IPM-FNB combined with sulbactam shows promising activity in vitro against CRAB that may warrant further investigation. In addition, IPM-FNB combined with aztreonam demonstrates promising in vitro synergistic activity against CREC and CRKP, including both KPC-2- and NDM-producing isolates. Additive activity was most common in IPM-FNB combinations against CRPA.</p>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":" ","pages":"108025"},"PeriodicalIF":5.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Beta-Lactam concentration and Liver Injury in Critically Ill Patients.","authors":"Anita Farinella, Federica Montanaro, Michele Salvagno, Gaetano Scaramuzzo, Carlo Alberto Volta, Savino Spadaro, Ana Cunha, Stefano Zorzi, Maya Hites, Fabio Silvio Taccone, Elisa Gouvêa Bogossian","doi":"10.1016/j.ijantimicag.2026.108023","DOIUrl":"https://doi.org/10.1016/j.ijantimicag.2026.108023","url":null,"abstract":"<p><strong>Introduction: </strong>Therapeutic drug monitoring (TDM) may help optimize antibiotic dosing while minimizing toxicity in critically ill patients. This study investigated whether elevated plasma concentrations of beta-lactam antibiotics assessed by TDM were associated with an increased risk of liver injury in the intensive care unit (ICU) setting.</p><p><strong>Methods: </strong>We conducted a single center retrospective cohort study of ICU patients admitted to the Hôpital Universitaire de Bruxelles (2009-2014) who underwent TDM for beta-lactam antibiotics. Total plasma trough concentrations (C₀) were measured for piperacillin-tazobactam, meropenem and ceftazidime/cefepime. Liver injury was identified via liver function tests on the day of TDM and classified into hepatocellular, cholestatic, or mixed patterns.</p><p><strong>Results: </strong>Among 425 ICU patients with β-lactam TDM, 154 (36.2%) developed liver injury, including hepatocellular (8.7%), cholestatic (22.1%), and mixed (5.4%) patterns. TDM was performed a median of 5 days after ICU admission and 2 days after antibiotic initiation. The overall C₀ for PIP, MER and CEF were 37.8 (12.0-69.5), 4.5 (2.5-9.0) and 29.8 (18.7-47) mg/L, respectively. Patients with DILI had numerically higher beta-lactam C₀ than patients without DILI; however, this difference was only statistically significant in patients treated with PIP (44.7 [23.4-76.7] vs. 30.6 [6.4-59.5]; p=0.03). In a logistic regression analysis, C₀ was not independently associated with liver injury. Considering only patients that received piperacillin/tazobactam (n = 164), a piperacillin C₀ >20.95 mg/L had a sensitivity of 78% and specificity of 43% to identify patients with liver injury. In a multivariate analysis, piperacillin C₀ >20.95 mg was independently associated with the development of liver injury.</p><p><strong>Conclusions: </strong>In this cohort of patients, no clear association was found between trough concentration of beta-lactams and the development of liver injury. The potential hepatoxicity of piperacillin warrants further investigation.</p>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":" ","pages":"108023"},"PeriodicalIF":5.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of P-CABs-Based Bismuth Quadruple Therapy for First-line Helicobacter pylori Eradication: A Real-World Evidence Study.","authors":"Kunping Ju, Longfei Sun, Yuting Guo, Lili Zhang, Fengqing Liu, Zhenzhen Zhai, Hongyu Zhao, Ruili Li, Baobao Wang, Miao Duan, Qingzhou Kong, Yueyue Li, Xiuli Zuo, Yanqing Li","doi":"10.1016/j.ijantimicag.2026.108018","DOIUrl":"https://doi.org/10.1016/j.ijantimicag.2026.108018","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the efficacy and safety of various bismuth-containing quadruple therapies (BQTs) with potassium-competitive acid blockers (P-CABs) for Helicobacter pylori eradication.</p><p><strong>Methods: </strong>This multicenter retrospective cohort study evaluated 1730 treatment-naïve patients receiving P-CABs-based BQTs (P-BcQT). The regimens consisted of one P-CAB (vonoprazan or tegoprazan), bismuth, and two antibiotics including amoxicillin, clarithromycin, levofloxacin, tetracycline and cefuroxime, with a treatment duration of 10 to 14 days. We comprehensively assessed eradication rates, adverse events, and risk factors predictive of positive results. Receiver operating characteristic curve analysis identified optimal cut-off values for predicting outcomes, while multivariate regression determined independent predictors of treatment failure and adverse events.</p><p><strong>Results: </strong>The overall eradication rate was 92.3% and 92.9% by modified intention-to-treat and per-protocol analysis, respectively. Multivariate analysis revealed three independent predictors of failure: high body surface area (BSA ≥1.76 m²) (OR: 1.545, 95% CI: 1.010-2.362, P = 0.045), low compliance (OR: 3.442, 95% CI: 1.891-6.266, P < 0.001), and suboptimal antibiotic combinations. Especially, amoxicillin/clarithromycin (P = 0.005) and cefuroxime/levofloxacin regimens (P < 0.001) demonstrated significantly higher failure trend compared to amoxicillin/tetracycline combinations. The adverse event rate was 26.9%, with lower body mass index (BMI <28.38 kg/m²) (P = 0.011) and long treatment duration (P = 0.007) emerging as independent risk factors. Overall compliance was excellent (95.6%).</p><p><strong>Conclusions: </strong>P-BcQT demonstrated promising efficacy as a first-line H. pylori treatment regimen. However, regimens containing clarithromycin or levofloxacin appear less effective. Future optimization may focus on shorter treatment durations, personalized dosing adjustments and regional resistance patterns.</p>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":" ","pages":"108018"},"PeriodicalIF":5.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virologic Outcomes of Bictegravir/Emtricitabine/Tenofovir Alafenamide in Advanced HIV-1 Disease: A Propensity-Weighted Multicenter Cohort Study.","authors":"Tsung- Yu Tsai, Chin-Shiang Tsai, Sung-Hsi Huang, Tzong-Yow Wu, Po-Wei Chiu, Wang- Da Liu, Andrew Po-Liang Chen, Kuan-Yin Lin, Chien-Ching Hung","doi":"10.1016/j.ijantimicag.2026.108020","DOIUrl":"https://doi.org/10.1016/j.ijantimicag.2026.108020","url":null,"abstract":"<p><strong>Background: </strong>Rapid and effective viral suppression (VS) is fundamental to immune reconstitution and reducing clinical morbidity in people with HIV-1. This study aimed to evaluate the effectiveness of co-formulated bictegravir, emtricitabine, and tenofovir alafenamide (BIC/FTC/TAF) to achieve VS among people with advanced HIV-1 disease (AHD).</p><p><strong>Methods: </strong>We conducted a multicenter retrospective cohort study of newly diagnosed people with AHD between 2018 and 2024. Clinical outcomes were compared between those initiating BIC/FTC/TAF and those initiating other regimens. The primary outcome was ever achieving plasma HIV-1 RNA viral load (VL) <200 copies/mL within 48 weeks. Inverse probability of treatment weighting (IPTW) was applied to adjust for baseline confounding; weighted logistic regression and the Fine-Gray hazard models were used to evaluate associations between initial regimens and clinical outcomes.</p><p><strong>Results: </strong>Of 467 people with AHD included, the median baseline CD4 count was 61 cells/mm³; 248 (53.1%) initiated BIC/FTC/TAF, while 219 (46.9%) initiated others. In unadjusted analysis, the BIC/FTC/TAF group had similar rates of ever achieving VL <200 copies/mL (93.2% vs 91.3%) and CD4 recovery >200 cells/mm³ (66.5% vs 68.5%) within 48 weeks, but it demonstrated a significantly higher rate of ≥10,000-fold decline in VL within 4 weeks (37.8% vs 27.0%). In IPTW-adjusted analysis, initiation of BIC/FTC/TAF was independently associated with achieving the primary outcome (weighted OR 2.44; 95% CI 1.01-5.93), with consistent findings in sensitivity analyses. Regimen changes were less frequent in the BIC/FTC/TAF group (2.8% vs 10.5%).</p><p><strong>Conclusion: </strong>BIC/FTC/TAF is highly effective in facilitating VS among people with AHD.</p>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":" ","pages":"108020"},"PeriodicalIF":5.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}