Journal of Infection and Chemotherapy最新文献

{"title":"Comparison of adverse reactions to COVID-19 XBB.1.5 and influenza vaccination in the 2023-24 Japanese influenza season","authors":"Naoki Kawai ,&nbsp;Hideyuki Ikematsu ,&nbsp;Takuma Bando ,&nbsp;Woon Joo Lee ,&nbsp;Shinro Matsuura ,&nbsp;Maeda Tetsunari ,&nbsp;Mariko Echizen ,&nbsp;Takashi Kawashima","doi":"10.1016/j.jiac.2025.102728","DOIUrl":"10.1016/j.jiac.2025.102728","url":null,"abstract":"<div><h3>Introduction</h3><div>Adverse reactions to the most recent XBB.1.5 monovalent COVID-19 and seasonal influenza vaccines administered from September to December in 2023 were compared.</div></div><div><h3>Methods</h3><div>Outpatients were administered the COVID-19 and/or influenza vaccine. Patients reported five local and six systemic solicited adverse reactions for seven days through a self-report diary. The data from 217 diaries for the COVID-19 vaccine and 140 diaries for the influenza vaccine were collected and analyzed, including 43 diaries from subjects who received both vaccines and recorded a diary, for a total of 357 diaries from 314 subjects.</div></div><div><h3>Results</h3><div>Among the systemic reactions, fatigue, headache, and myalgia were more frequent with the COVID-19 vaccine (p &lt; 0.001, p &lt; 0.01, p &lt; 0.001, respectively). The local adverse reactions of redness and swelling were significantly more frequent with the influenza vaccine (p &lt; 0.001 and p &lt; 0.05, respectively). For both vaccines, most of the systemic and local reactions were less frequent in subjects 65 years or over than in those under 65. No significant increase in adverse reactions was observed for vaccinations within 14 days compared to those more than 14 days apart or the COVID-19 vaccine alone. Multiple regression analysis also showed that systemic reactions including fatigue, headache, and myalgia, to COVID-19 vaccine, were negatively correlated with age (p &lt; 0.001, p &lt; 0.001 and p = 0.005, respectively).</div></div><div><h3>Conclusions</h3><div>These findings suggest that there are significant differences between the COVID-19 and influenza vaccines in terms of the composition of the adverse reactions and there is a lower incidence of adverse reactions for persons 65 years or older.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 8","pages":"Article 102728"},"PeriodicalIF":1.9,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling mortality risks in pediatric oncology: Exploring bloodstream coinfections and inflammatory biomarkers in COVID-19","authors":"Rasha M. Abdel-Hamid ,&nbsp;Rasha M. Allam ,&nbsp;Lobna Refaat ,&nbsp;Hend A. Nooh ,&nbsp;Farida M. Mahmoud ,&nbsp;Ahmed Bayoumi ,&nbsp;Safaa S. Hassan","doi":"10.1016/j.jiac.2025.102741","DOIUrl":"10.1016/j.jiac.2025.102741","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric oncology patients face heightened mortality rates, primarily due to bacteremia exacerbated by the ongoing COVID-19 pandemic. Given hyperinflammation's role in coronavirus pathogenesis and the importance of inflammatory biomarkers in adults, we aim to explore 60-day mortality predictors in children with cancer, where research remains limited. This study aimed to investigate predictors of mortality in pediatric oncology patients with COVID-19, focusing on bacteremia and inflammatory biomarkers.</div></div><div><h3>Methods</h3><div>Sixty pediatric cancer patients with COVID-19 and 60 with bacteremia (no COVID-19) were included. Bloodstream coinfections were identified, and causative species with antimicrobial sensitivities were characterized. Various inflammatory indices were calculated. Survival analyses identified risk factors for COVID-19 patients’ mortality. Mortality factors in bacteremia patients were examined.</div></div><div><h3>Results</h3><div>The 60-day OS rate of COVID-19 pediatrics was 81.7 %. Worse outcomes were associated with solid tumors, ICU admission, moderate/severe COVID-19, lymphopenia, high NLR, high CLR, and Gram-negative bacteremia (<em>p</em>-values = 0.002, 0.025, 0.042, 0.013, 0.047, 0.052, and 0.025). Multivariate analysis identified solid tumors, high NLR, and high CLR as independent factors for lower OS (<em>p</em>-values = 0.003, 0.046, and 0.046). Bacteremia was revealed in 24 COVID-19 patients (40 %). In patients with bacteremia (n = 84), non-survivors exhibited higher rates of ICU admission, fever, Gram-negative bacteria (GNB), and elevated CRP (<em>p</em>-values = 0.007, 0.038, &lt;0.001, and 0.006), with multivariate analysis identifying GNB and ICU as independent mortality risk factors (<em>p</em>-values = 0.002 and 0.031). <em>Conclusions</em>: NLR and CLR predict mortality in pediatric oncology patients with COVID-19, with solid tumors heightening risk. Infection severity, GNB, and patient condition significantly influence outcomes of bacteremia cancer patients.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 7","pages":"Article 102741"},"PeriodicalIF":1.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 pandemic on the regional epidemiology of methicillin-resistant Staphylococcus aureus in the Kumamoto region","authors":"Keiichi Yamamoto ,&nbsp;Hideyuki Hayashi ,&nbsp;Kanako Mizuta ,&nbsp;Rika Fukushima ,&nbsp;Kenyu Hashimoto ,&nbsp;Hirotomo Nakata ,&nbsp;Hitomi Maeda ,&nbsp;Tomohiro Sawa ,&nbsp;Tatsuya Kawaguchi ,&nbsp;Hiroyasu Tsutsuki","doi":"10.1016/j.jiac.2025.102743","DOIUrl":"10.1016/j.jiac.2025.102743","url":null,"abstract":"<div><div>The COVID-19 pandemic caused the collapse of various health systems globally. Several studies have examined the impact of the increase in COVID-19 patients on antimicrobial resistance, but conclusions are controversial. This study aimed to clarify the impact of the COVID-19 pandemic on MRSA trends in the Kumamoto region. We analyzed the detection trends of MRSA using bacterial surveillance data from facilities in the Kumamoto Healthcare-associated Infection Prevention and Control Network from 2017 to 2022. Compared to pre-pandemic data, MRSA detection rates since 2020 have decreased. This was thought to be due to a decrease in the number of bacteriological tests of respiratory specimens, in which MRSA was frequently detected before the pandemic. On the other hand, that of skin and soft tissue specimens were not affected by the pandemic. The MRSA detection rate in these specimens showed a downward trend, suggesting that the increased awareness of infection control measures, including hand hygiene during the pandemic possibly had an impact. We further performed POT method analysis using a clinically isolated MRSA library from Kumamoto University Hospital. The monthly detection rate of the predominant POT type fluctuated from FY2020 to FY2022, and this clonal shift may have contributed to the decline in the MRSA detection rate in the Kumamoto region during the pandemic period. Throughout the pandemic, MRSA clones continued to evolve. Notably, the prevalence of clone 106-247-33, which was dominant in the early phase, may have fluctuated, potentially in relation to variations in the stringency of infection control measures. Therefore, further reductions in MRSA can be expected with maintaining robust implementation of infection control.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 8","pages":"Article 102743"},"PeriodicalIF":1.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stability of a blaGES-5-carrying plasmid in a Serratia marcescens nosocomial outbreak","authors":"Shoko Komatsu,&nbsp;Ryohei Nomoto,&nbsp;Noriko Nakanishi","doi":"10.1016/j.jiac.2025.102742","DOIUrl":"10.1016/j.jiac.2025.102742","url":null,"abstract":"<div><div>In 2020, an outbreak of <em>bla</em>_GES-5-carrying plasmid, p2020-O-9, harboring <em>S. marcescens</em> occurred in an intensive care unit in Kobe City, Japan [1]. During the outbreak, strains with and without p2020-O-9 were simultaneously isolated from three patients; hence, we evaluate the stability of p2020-O-9 and its contribution to carbapenem resistance. Growth and transcriptional expression of <em>bla</em>_GES-5 were affected by the presence of p2020-O-9 at a meropenem concentration of at least 4 μg/mL. The <em>bla</em>_GES-5-harboring plasmid could be transformed into <em>Escherichia coli</em> via electroporation, but not conjugation. The p2020-O-9 plasmid was highly unstable, and complete loss was observed at the 25th serial passage when antibiotic pressure was withdrawn. Therefore, the <em>bla</em>_GES-5-harboring plasmid p2020-O-9 was unstable and non-conjugative, and contributed to meropenem resistance in a concentration-dependent manner in the previously reported <em>S. marcescens</em> nosocomial outbreak.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 7","pages":"Article 102742"},"PeriodicalIF":1.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nationwide epidemiological survey of coronavirus disease 2019-associated pulmonary aspergillosis in Japan","authors":"Yuya Ito ,&nbsp;Takahiro Takazono ,&nbsp;Hotaka Namie ,&nbsp;Masato Tashiro ,&nbsp;Hiroshi Kakeya ,&nbsp;Yoshitsugu Miyazaki ,&nbsp;Hiroshi Mukae ,&nbsp;Hiroshige Mikamo ,&nbsp;Tomoo Fukuda ,&nbsp;Kazutoshi Shibuya ,&nbsp;Koichi Izumikawa","doi":"10.1016/j.jiac.2025.102739","DOIUrl":"10.1016/j.jiac.2025.102739","url":null,"abstract":"<div><h3>Background</h3><div>Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is a severe complication of COVID-19 with a poor prognosis. In this study, we aimed to analyze the nationwide epidemiology of CAPA in Japan.</div></div><div><h3>Methods</h3><div>This nationwide retrospective study involved data of 98 patients with CAPA reported in 221 hospitals in Japan between January 2020 and August 2023, using both online and paper-based questionnaires. We investigated the clinical characteristics of CAPA, assessed outcomes using Kaplan–Meier curves, and identified independent predictors of 90-day mortality using Cox proportional hazards analysis.</div></div><div><h3>Results</h3><div>The median age of the patients with CAPA was 71 years, and 71.4 % were men. The positivity rates for β-D-glucan and serum galactomannan antigen were 59.1 % and 68.4 %, respectively, while chest computed tomography revealed cavities in 25.5 % of patients. The 30-day and 90-day mortality rates were 50.0 % and 55.1 %, respectively. Kaplan–Meier analysis showed that the mortality rate of patients treated with echinocandin monotherapy was significantly higher than that of patients treated with other antifungals (log-rank test, <em>p</em> = 0.04). Multivariate analysis identified a neutrophil count of ≥10,000/μL (hazard ratio [HR]: 2.67, 95 % confidence interval [CI]: 1.49–4.89) and echinocandin monotherapy (HR: 2.06, 95 % CI: 1.01–3.93) as independent predictors of 90-day mortality. Patients treated with echinocandin monotherapy were older, and <em>Aspergillus</em> spp. was not isolated in half of these patients.</div></div><div><h3>Conclusion</h3><div>This study provides a comprehensive overview of CAPA in Japan. Appropriate antifungal therapy is essential to improve the prognosis of patients with CAPA.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 7","pages":"Article 102739"},"PeriodicalIF":1.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics of pediatric parapertussis: A single-center case-control study","authors":"Ken Okamoto ,&nbsp;Takanori Funaki ,&nbsp;Satsuki Kidokoro ,&nbsp;Akira Ishiguro ,&nbsp;Chikara Ogimi","doi":"10.1016/j.jiac.2025.102740","DOIUrl":"10.1016/j.jiac.2025.102740","url":null,"abstract":"<div><div>Parapertussis in children is often regarded as a disease similar to pertussis but remains underrecognized in Japan, where it is not a notifiable disease. This study aimed to elucidate its clinical and epidemiological features. A retrospective study was conducted at a pediatric center in Tokyo from October 2020 to November 2023. Patients under 18 years of age who tested positive for <em>Bordetella parapertussis</em> using the FilmArray® Respiratory Panel 2.1 were included. Data on demographics, clinical features, and laboratory results were collected from electronic records. Patients were classified into mono-infection (<em>B. parapertussis</em> only) or co-infection (with other pathogens). Fisher's exact and Mann-Whitney U tests were used for group comparisons, as appropriate. Among 11,384 tests, 45 were positive for <em>B. parapertussis</em>, first detected in August 2021. By 2023, the detection rate per test was 1.0 % (40/3941). The median age was 3.7 years, with 51.1 % male. Of the cases, 82.2 % had co-infections, most commonly with human rhinovirus/enterovirus (59.5 %). Symptoms were mild, with cough in 71.1 % and fever ≥38 °C in 46.6 %, and no patients required mechanical ventilation or intensive care. Azithromycin was administered to 64.4 % of patients. Lymphocyte counts were significantly lower in mono-infected patients than in co-infected patients (median [interquartile range]: 1065/μL [626–1611] vs. 5289/μL [3637–9655], respectively, <em>P</em> = 0.02). This study shows that parapertussis generally follows a mild clinical course but is often found with other pathogens. Given the lack of nationwide surveillance for parapertussis in Japan, more data are needed to assess the disease burden and develop management strategies.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 7","pages":"Article 102740"},"PeriodicalIF":1.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successive SARS-CoV-2 mutations in a highly susceptible host: A case report of persistent viremia and fatality","authors":"Yuko Danzuka ,&nbsp;Keiji Nakamura ,&nbsp;Shinya Matsumoto ,&nbsp;Yoshitaka Etoh ,&nbsp;Sho Yamasaki ,&nbsp;Koji Takayama ,&nbsp;Masayuki Murata ,&nbsp;Nobuyuki Shimono","doi":"10.1016/j.jiac.2025.102737","DOIUrl":"10.1016/j.jiac.2025.102737","url":null,"abstract":"<div><div>A 71-year-old female with post-treatment follicular lymphoma developed COVID-19 with persistent viremia. Despite the initiation of remdesivir on day 23, she remained SARS-CoV-2 PCR-positive and ultimately succumbed to respiratory failure on day 79. Whole-genome analysis of RNA extracted from a post-mortem nasopharyngeal swab identified multiple mutations, including P323L/G671S, which enhances viral replication, and V792I, associated with remdesivir resistance. This case highlights the challenges of managing persistent SARS-CoV-2 infection in immunocompromised patients and underscores the impact of delayed treatment and antiviral resistance.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 7","pages":"Article 102737"},"PeriodicalIF":1.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged Bacillus cereus bacteremia: case report and literature review","authors":"Yuki Hirao ,&nbsp;Hiroshi Morioka ,&nbsp;Tomomasa Agata ,&nbsp;Masaki Iimura ,&nbsp;Shunichi Taki ,&nbsp;Tetsuya Yagi","doi":"10.1016/j.jiac.2025.102736","DOIUrl":"10.1016/j.jiac.2025.102736","url":null,"abstract":"<div><div>A 77-year-old man, initially diagnosed with pneumonia presented with fever and was administered continuous amino acid preparations and meropenem. <em>Bacillus cereus</em> was isolated from two separate sets of blood cultures, leading to a diagnosis of catheter-related bloodstream infection. Despite treatment with teicoplanin (TEIC) and additional antibiotics, <em>B. cereus</em> was continuously yielded from blood cultures for approximately four weeks. Ultimately, the patient was successfully treated with a combination of TEIC and clindamycin for six weeks, along with gentamicin for two weeks. This case report further reviews 17 cases of persistent <em>B. cereus</em> bacteremia. These cases provide valuable insights into the management of challenging cases of <em>B</em>. <em>cereus</em> bacteremia.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 7","pages":"Article 102736"},"PeriodicalIF":1.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epstein–Barr virus-associated infectious mononucleosis exhibits substantially higher non-treponemal test titers in biological false-positive reactions","authors":"Naoki Matsuura ,&nbsp;Takashi Matono ,&nbsp;Miho Kuroki ,&nbsp;Kenta Saitou","doi":"10.1016/j.jiac.2025.102738","DOIUrl":"10.1016/j.jiac.2025.102738","url":null,"abstract":"<div><h3>Objectives</h3><div>Biological false-positive (BFP) reactions in rapid plasma reagin (RPR) tests can complicate syphilis screening interpretation. Although Epstein–Barr virus-associated infectious mononucleosis (EBV-IM) is a known cause of BFP reactions, the characteristics of RPR titers in such cases remain unclear. This study aimed to compare the RPR titers in BFP reactions between patients with EBV-IM and those with other underlying conditions.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the RPR and <em>Treponema pallidum</em> hemagglutination assay (TPLA) results of all tests performed at a community hospital in Japan between April 2016 and March 2024. BFP reactions were defined as positive RPR and negative TPLA results. Clinical characteristics and RPR titers were compared between EBV-IM and other causes of BFP reactions.</div></div><div><h3>Results</h3><div>Among 154 confirmed BFP cases, EBV-IM cases (n = 7) showed significantly higher RPR titers than other underlying conditions (n = 147) (median 28.5 relative units [RU], interquartile range [IQR]: 11.2–31.2 vs. 1.9 RU, IQR: 1.2–4.3, <em>p</em> &lt; 0.001), despite a significantly younger age (median age 18 years, IQR: 17.4–25 vs. 72 years, IQR, 44.5–82, <em>p</em> &lt; 0.001). Among all BFP cases, neoplasms were the most common underlying condition (22.1 %), followed by digestive diseases (8.4 %) and infectious diseases (7.8 %).</div></div><div><h3>Conclusions</h3><div>EBV-IM is associated with distinctively high RPR titers in BFP reactions, in contrast to the typically low titers observed under other conditions. Clinicians should be aware that high RPR titers can occur during BFP reactions, particularly in young patients with suspected EBV infection.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 7","pages":"Article 102738"},"PeriodicalIF":1.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of antibiotic adverse events","authors":"Toshiharu Urakami,&nbsp;Takashi Matono","doi":"10.1016/j.jiac.2025.102735","DOIUrl":"10.1016/j.jiac.2025.102735","url":null,"abstract":"<div><h3>Purpose</h3><div>Antibiotic-associated adverse drug events (ADEs) are common and diverse in clinical practice, yet healthcare professionals often lack sufficient understanding of them. An ill-considered change to an alternative agent whent symptoms of suspected ADEs appear can lead to excessive overuse and misuse of antibiotics. Proper management of ADEs is part of antimicrobial stewardship.</div></div><div><h3>Areas covered</h3><div>This review describes clinical characteristics, diagnosis and management of ADEs, featuring drug fever, rash, nephrotoxicity, liver injury, interstitial pneumonitis, rhabdomyolysis, encephalopathy, QT prolongation, thrombocytopenia and neutropenia.</div></div><div><h3>Summary</h3><div>Healthcare professionals should be familiar with the typical symptoms, time course and likely causative agent for each adverse reaction. Early detection and proper judgement are important. In sever case, early discontinuation of the causative agent and proper treatment are required. If it is not fatal, continuing the suspected agent and careful monitoring may help identify the causative agent. Especially in penicillin allergies, it is important to remember that most patients labeled as allergic are, in fact, misclassified.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 7","pages":"Article 102735"},"PeriodicalIF":1.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}