International Journal of Antimicrobial Agents最新文献

{"title":"Microfluidic evolution-on-a-chip reveals distinct evolution of polymyxin resistance associated with fitness optimum in Acinetobacter baumannii","authors":"Jinxin Zhao , Yaqi Zhang , Yu-Wei Lin , Xingjian Wang , Phillip J. Bergen , Yan Zhu , Jing Lu , Meiling Han , Jian Li","doi":"10.1016/j.ijantimicag.2025.107538","DOIUrl":"10.1016/j.ijantimicag.2025.107538","url":null,"abstract":"","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 3","pages":"Article 107538"},"PeriodicalIF":4.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077763","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":"Activity of imipenem-relebactam, ceftolozane-tazobactam and comparators against clinical isolates of Enterobacterales and Pseudomonas aeruginosa causing severe infections in hematological and oncological patients: A prospective multicenter study","authors":"Emilia Cercenado ,&nbsp;Luis Alcalá ,&nbsp;Álvaro Irigoyen-von-Sierakowski ,&nbsp;Belén Rodríguez-Sánchez ,&nbsp;Mercedes Marín","doi":"10.1016/j.ijantimicag.2025.107534","DOIUrl":"10.1016/j.ijantimicag.2025.107534","url":null,"abstract":"<div><h3>Objectives</h3><div>Studies regarding the activity of antimicrobials against isolates causing severe infections in oncological and hematological patients are scarce. Ceftolozane-tazobactam (TOL/TAZ) and imipenem-relebactam (IMP/REL) are among the new antimicrobials active against multiresistant gramnegative microorganisms. We evaluate the <em>in vitro</em> activity of these antimicrobials and comparators against recent clinical isolates from hematology and oncology patients in Spain.</div></div><div><h3>Methods</h3><div>A total of 55 centers participated in a nationwide study. The isolates were prospectively recovered from patients with bacteremia, lower respiratory tract infections (LRTIs), complicated urinary infections (cUTI), and complicated intra-abdominal infections (cIAIs). The activities of TOL/TAZ, IMP/REL, imipenem (IMP), meropenem (MER), ceftazidime (CAZ), cefepime (FEP), piperacillin-tazobactam (PIP/TAZ), levofloxacin (LEV), and amikacin (AK) were studied following the EUCAST guidelines. Resistance mechanisms were detected by standard methods.</div></div><div><h3>Results</h3><div>A total of 997 isolates (563 Enterobacterales (EB) and 434 <em>Pseudomonas aeruginosa</em> (PA)) were collected. The source of EB/PA were: bacteremia (n = 347/182), LRT (n = 51/139), urine (n = 95/64), and intraabdominal samples (n = 70/49). Among EB, 93.6%, 98.9%, 98.6%, 87.4%, 82.2%, 93.6%, 98.6%, 73.7%, and 97.3% were susceptible to TOL/TAZ, IMP/REL, MER, FEP, CAZ, PIP/TAZ, IMP, LEV, and AK, respectively. The corresponding values for PA were 92.2%, 90.1%, 87.8%, 81.9%, 81.7%, 75.7%, 75.2%, 63.3%, and 96.1%, respectively. A total of 14/17 isolates (EB/PA) were carbapenenase-producers, and 82 EB isolates were ESBL-producers. IMP/REL restored the activity of IMP in 14,7% of IMP-resistant PA.</div></div><div><h3>Conclusions</h3><div>TOL/TAZ and IMP/REL were the most active of the beta-lactams against PA. IMP/REL was the most active agent against EB; 30% of the isolates were resistant to levofloxacin.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 3","pages":"Article 107534"},"PeriodicalIF":4.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012082","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":"Unveiling the clonal dynamics and transmission mechanism of carbapenem-resistant klebsiella pneumoniae in the ICU environment","authors":"Xinhong Han ,&nbsp;Meijun Song ,&nbsp;Qing Yu ,&nbsp;Junxin Zhou ,&nbsp;Huangdu Hu ,&nbsp;Yan Jiang ,&nbsp;Qiucheng Shi ,&nbsp;Yongyi Chen ,&nbsp;Qing Yang ,&nbsp;Xiaoxing Du ,&nbsp;Caiping Mao ,&nbsp;Yunsong Yu","doi":"10.1016/j.ijantimicag.2025.107532","DOIUrl":"10.1016/j.ijantimicag.2025.107532","url":null,"abstract":"<div><div>CRKP infections are a significant public health threat due to their high mortality and limited treatment options. This study aimed to investigate CRKP colonization and clonal dissemination mechanism in an ICU. From August 2019 to December 2019, 8668 samples were collected from patients and the ICU environment for CRKP screening. Positive samples underwent antimicrobial susceptibility testing, whole-genome sequencing, and molecular epidemiological analysis. Disinfectant sensitivity and ultraviolet (UV) resistance experiments were conducted to evaluate clonal persistence. The overall CRKP positive rate was 4.85% (420/8668), with higher rates in patients (14.77%, 247/1672) compared to environmental surfaces (2.47%, 173/6996). Intestinal and ventilator-related surfaces were identified as high-risk colonization sites. Molecular analysis revealed six sequence types, with ST11-KL64 (44.05%, 185/420) and ST15-KL112 (24.05%, 101/420) as dominant clones, both exhibiting elevated virulence. Notably, the emerging ST15-KL112 clone demonstrated enhanced resistance to disinfectants including chlorhexidine (MIC 8 mg/L) and benzalkonium chloride (32 mg/L). While most isolates produced KPC-2 (72.86%), OXA-232 prevalence (25.23%) exceeded prior reports. Crucially, ST11 strains survived standard UV disinfection (60-second exposure) at rates 1.3- to 5-fold higher than other clones (p &lt; 0.01). Our findings highlight the critical role of disinfectant resistance in sustaining CRKP transmission. To mitigate outbreaks, we advocate for disinfectant rotation protocols targeting disinfectant-resistant clones and prolonged UV exposure times in ICUs. The persistence of resistant CRKP clones in the ICU environment, particularly their high tolerance to disinfectants, highlights the urgent need for enhanced infection control strategies, including tailored disinfection protocols and surveillance programs.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 3","pages":"Article 107532"},"PeriodicalIF":4.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015030","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":"Genetic framework and evolutionary dynamics of mcr-positive Klebsiella pneumoniae from 2000 to 2023","authors":"Xi-Wei Zhang ,&nbsp;Xi-Yi Huang ,&nbsp;Zhuo-Yang Zhou ,&nbsp;Bo-Lin Li ,&nbsp;Jie-Hong Lu ,&nbsp;Jing-Jie Song ,&nbsp;Xiao-Yan Li","doi":"10.1016/j.ijantimicag.2025.107533","DOIUrl":"10.1016/j.ijantimicag.2025.107533","url":null,"abstract":"<div><h3>Objective</h3><div>The international transmission of the colistin resistance gene <em>mcr</em> in Enterobacteriaceae poses significant public health burdens, while the understanding of the population structure and evolutionary history of <em>mcr</em>-positive <em>Klebsiella pneumoniae</em> worldwide remains unclear.</div></div><div><h3>Methods</h3><div>Here, we conducted a genomic analysis on 463 sequences of <em>K. pneumoniae</em> harbouring <em>mcr</em> genes from public database between 2000 and 2023.</div></div><div><h3>Results</h3><div>A total of 6 <em>mcr</em> variants (<em>mcr-1</em>, -<em>2</em>, -<em>3</em> and -<em>8</em> to -<em>10</em>) were detected, with <em>mcr</em>-<em>9</em> (36.1%), <em>mcr</em>-<em>1</em> (33.7%) and <em>mcr</em>-<em>8</em> (29.2%) genes being the most common. Of total isolates, 43.4% (201/463) carried carbapenemase genes (<em>bla</em>_NDM, <em>bla</em>_KPC, <em>bla</em>_IMP, <em>bla</em>_{OXA-48/181/232}, <em>bla</em>_VIM and <em>bla</em>_GES) and 15.3% of isolates (71/463) contained hypervirulent genes (<em>iucA</em> or <em>iroB</em>). Correlation analysis indicated <em>mcr</em>-<em>1</em>/<em>8</em>/<em>9</em> genes were positively correlated with specific genomic elements that were rarely described, including <em>mcr</em>-<em>1</em> with <em>iucABC</em> and <em>iutA; mcr</em>-<em>8</em> with <em>oqxB; mcr-9</em> with <em>dfrA19</em>; and IS<em>Esa</em> and repA (R absolute value &gt; 0.3; <em>p</em> &lt; 0.01). The population of <em>K. pneumoniae</em> can be classified into 6 clusters, some isolates co-harbouring <em>mcr</em> and carbapenemase genes exhibited high level of genetic similarity and dispersed in several countries, indicating the possibility of clonal transmission. <em>mcr</em>-<em>9</em> gene was introduced into <em>K. pneumoniae</em> in 1978 before the time of <em>mcr</em>-<em>1</em> gene in 1988 and <em>mcr</em>-<em>8</em> gene in 1993. We found <em>mcr</em>-<em>1</em>/<em>8</em>/<em>9</em> genes in <em>K. pneumoniae</em> evolved high-risk lineages in specific geographical location (China, Thailand and the United Kingdom) that most isolates typically contained <em>iucA, bla</em>_NDM or <em>bla</em>_KPC.</div></div><div><h3>Conclusions</h3><div>This study highlighted that continuous surveillance for the evolution of <em>mcr</em>-positive <em>K. pneumoniae</em> harbouring <em>iucA</em> or carbapenemase genes is essential.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 3","pages":"Article 107533"},"PeriodicalIF":4.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965747","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":"Title Page & Editorial Board","authors":"","doi":"10.1016/S0924-8579(25)00086-X","DOIUrl":"10.1016/S0924-8579(25)00086-X","url":null,"abstract":"","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 1","pages":"Article 107529"},"PeriodicalIF":4.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905845","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":"Effects of different resistance mechanisms on bacterial response to meropenem, ciprofloxacin, and their combination described by next-generation mechanism-based modelling","authors":"Alice E. Terrill ,&nbsp;Jessica R. Tait ,&nbsp;Kate E. Rogers ,&nbsp;Wee L. Lee ,&nbsp;Carla López-Causapé ,&nbsp;Xiaoyu Wang ,&nbsp;Jiangning Song ,&nbsp;Roger L. Nation ,&nbsp;Antonio Oliver ,&nbsp;Cornelia B. Landersdorfer","doi":"10.1016/j.ijantimicag.2025.107528","DOIUrl":"10.1016/j.ijantimicag.2025.107528","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the effects of different bacterial resistance mechanisms on the response of isogenic strains of <em>Pseudomonas aeruginosa</em> to meropenem and ciprofloxacin, in monotherapy and combination.</div></div><div><h3>Methods</h3><div>Seven isogenic <em>P. aeruginosa</em> strains were used: the PAO1 wild-type reference parent strain, PAΔAD (AmpC overexpression), PAOD1 (OprD porin loss), PAΔmexR (MexAB-OprM overexpression), and strains with two of these mutations (PAΔDMxR, PAOD1MxR, PAOD1ΔD). Each strain was exposed to constant meropenem and/or ciprofloxacin concentrations over 72 h. Pharmacokinetic/pharmacodynamic indices, i.e. the percentage of time the free meropenem concentration exceeded the MIC of the pathogen (%<em>f</em>T_˃MIC) and the ratio of the area under the free ciprofloxacin concentration-time curve over 24 h to MIC (<em>f</em>AUC/MIC), were calculated. A novel mechanism-based mathematical model was developed to describe the bacterial count profiles over time.</div></div><div><h3>Results</h3><div>The antibiotic exposures in monotherapy required to suppress regrowth varied between isogenic strains, even when strains had the same MIC; highlighting limitations of relying solely on MIC to inform dosing. Combination therapies, which cannot be predicted by pharmacokinetic/pharmacodynamic indices, were both synergistic and bactericidal at 72 h in five of the seven strains. All viable counts across all strains with monotherapies, combinations, and controls (<em>n</em> = 292 curves) were simultaneously modelled. The model accounted for different resistance mechanisms present across strains, while keeping all drug effect parameters the same between strains. The responses of strains with two resistance mutations were well described by the model developed from strains with a single mutation.</div></div><div><h3>Conclusions</h3><div>Overall, the mechanism-based mathematical model was predictive for &gt;96% of treatments.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 3","pages":"Article 107528"},"PeriodicalIF":4.9,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993142","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":"Antimicrobial suppressive therapy in prosthetic valve endocarditis rejected from surgery despite indication","authors":"Jérémie Tillement ,&nbsp;Nahema Issa ,&nbsp;Julien Ternacle ,&nbsp;Victor Hémar ,&nbsp;Antoine Beurton ,&nbsp;Olivier Busuttil ,&nbsp;Hélène Chaussade ,&nbsp;Marina Dijos ,&nbsp;Carine Greib ,&nbsp;Louis Labrousse ,&nbsp;Julien Peltan ,&nbsp;Olivia Peuchant ,&nbsp;Gaetane Wirth ,&nbsp;Claire Roubaud-Baudron ,&nbsp;Fabrice Camou ,&nbsp;Romain Boulestreau","doi":"10.1016/j.ijantimicag.2025.107526","DOIUrl":"10.1016/j.ijantimicag.2025.107526","url":null,"abstract":"<div><h3>Background</h3><div>Prosthetic valve endocarditis (PVE) incidence is rising in older patients, often rejected for surgery, leading them to a poor prognosis. Optimal antibiotic management is unknown for these patients. We compared the efficacy and safety of suppressive (SAT) versus conventional antimicrobial therapy (CAT) in this setting.</div></div><div><h3>Methods</h3><div>We conducted a prospective, multicentric, cohort study in southwest France including patients with PVE rejected from surgery despite indication, and surviving the initial 6 weeks of intravenous therapy. Beyond this period, patients could or not receive SAT, according to endocarditis team decision. Primary outcome was a composite endpoint of one-year all-cause mortality and PVE-related hospitalization. Secondary outcome was the incidence and nature of SAT-related adverse events.</div></div><div><h3>Results</h3><div>Between 2012 and 2022, 88 patients were included in the study, 42 receiving SAT and 46 CAT. Mean age was 69.4 ± 16.4 years and patients were highly comorbid (mean Charlson Comorbidity Index 5.6 ± 2.7). Main organisms included <em>Streptococcus</em> spp. (26/88, 29.5%) and <em>Staphylococcus aureus</em> (25/88, 28.4%). The primary composite outcome occurred in 7/42 (16.7%) patients in the SAT group, and 16/46 (34.8%) in the CAT group. Using a Cox model, SAT was significantly and independently associated with a lower incidence of one-year primary outcome (Hazard ratio 0.23, 95% CI 0.08–0.67, <em>P = 0.</em>007). Adverse effects in the SAT group were reported for 6/42 patients (14.3%). These effects were limited, causing only one treatment discontinuation.</div></div><div><h3>Conclusion</h3><div>In patients with PVE rejected from surgery despite indication, SAT may be safe and associated with better outcomes than CAT.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 3","pages":"Article 107526"},"PeriodicalIF":4.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985285","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":"A review of recently discovered mechanisms of cephalosporin resistance in Pseudomonas aeruginosa","authors":"Madeleine T. Hardie Boys,&nbsp;Daniel Pletzer","doi":"10.1016/j.ijantimicag.2025.107527","DOIUrl":"10.1016/j.ijantimicag.2025.107527","url":null,"abstract":"<div><div><em>Pseudomonas aeruginosa</em> frequently causes respiratory tract infections in immunocompromised patients as well as bloodstream, urinary tract, skin, and soft tissue infections. The increasing prevalence of multidrug-resistant <em>P. aeruginosa</em> strains poses a significant clinical challenge. Cephalosporin antibiotics from the β-lactam class are commonly prescribed to treat infections owing to their broad spectrum of activity and generally low host toxicity. <em>P. aeruginosa</em> utilizes β-lactamase enzymes, efflux pumps, and mutations in outer membrane porins/transporters and target proteins, all of which confer resistance to cephalosporin antibiotics.</div><div>This review categorizes resistance mechanisms into (i) well-characterized pathways, such as AmpC β-lactamase and Mex efflux pumps, (ii) recently described mutations linked to cephalosporin resistance (e.g., <em>ygfB, sltB1, pbp3, galU, pmrAB, fusA1</em>, and <em>gyrA</em>), and (iii) hypothetical β-lactamases and other mechanisms requiring further validation.</div><div>A variety of β-lactamase inhibitors have been developed to overcome β-lactamase-mediated resistance, but resistance has already been observed toward inhibitors via the accumulation of mutations within the targeted β-lactamase enzyme or increased activity of efflux pumps.</div><div>Understanding the regulation and pathways that lead to resistance is crucial in developing effective strategies to combat <em>P. aeruginosa</em> infections and extending the therapeutic lifespan of cephalosporin antibiotics.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 2","pages":"Article 107527"},"PeriodicalIF":4.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009501","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":"International Society of Antimicrobial Chemotherapy (ISAC) News and Information Page","authors":"","doi":"10.1016/j.ijantimicag.2025.107525","DOIUrl":"10.1016/j.ijantimicag.2025.107525","url":null,"abstract":"","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 1","pages":"Article 107525"},"PeriodicalIF":4.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877438","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 of antibiotics with Stevens–Johnson syndrome and toxic epidermal necrolysis: A real-world pharmacovigilance study","authors":"Xin Yan ,&nbsp;Junlong Ma ,&nbsp;Chengxian Guo ,&nbsp;Guoping Yang","doi":"10.1016/j.ijantimicag.2025.107524","DOIUrl":"10.1016/j.ijantimicag.2025.107524","url":null,"abstract":"<div><h3>Background</h3><div>Recent reports suggest antibiotics may cause severe allergic reactions, such as Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), exacerbating concerns about antibiotic safety.</div></div><div><h3>Objective</h3><div>Given the limited real-world evidence, this study aims to analyse the FDA Adverse Event Reporting System to investigate the association between various antibiotics and SJS/TEN risk.</div></div><div><h3>Methods</h3><div>Reports from infected patients (Q1 2014–Q4 2023) were extracted from the FDA Adverse Event Reporting System. Disproportionality analysis using information component identified risk signals of antibiotics associated with SJS/TEN. Subgroup analyses investigated the impact of age and gender on antibiotic-associated SJS/TEN. Also, a time of onset analysis was performed.</div></div><div><h3>Results</h3><div>Among 78 593 infected patients, 1221 cases of SJS/TEN were identified from 30 369 antibiotic administrations. The median age of patients with SJS was 63 y, and with TEN was 60 y. Eleven positive signal drugs were detected through disproportionality analysis. Amoxicillin, piperacillin, ceftriaxone, cefuroxime, cefotaxime, azithromycin, sulfamethoxazole, trimethoprim, vancomycin, doxycycline, and gentamicin exhibited significant risk associations with SJS/TEN. Sulfamethoxazole had the highest risk. Patients with pneumonia, urinary tract infections, and sepsis had higher risks than those with respiratory tract infections. Male patients using specific antibiotics may have a higher risk than females, with no significant age difference.</div></div><div><h3>Conclusions</h3><div>Antibiotics including penicillins, cephalosporins, azithromycin, sulfamethoxazole, trimethoprim, vancomycin, doxycycline, and gentamicin are associated with an increased risk of SJS/TEN, with sulfamethoxazole presenting the highest risk. Patients with pneumonia, urinary tract infections, and sepsis are particularly vulnerable. These findings highlight the need for personalized antibiotic regimens based on infection site and patient gender.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 2","pages":"Article 107524"},"PeriodicalIF":4.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947694","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}