Journal of Pharmaceutical Health Care and Sciences最新文献

{"title":"Prescription patterns of comedications associated with drug-drug interactions risk in HCV-infected patients undergoing direct-acting antiviral treatment: an analysis of an administrative claims database in Japan.","authors":"Daisuke Nakamoto, Yi Piao, Hajime Mizutani, Ryozo Wakabayashi, Satoshi Otokita, Alice Stead, Candido Hernandez, Masahisa Jinushi","doi":"10.1186/s40780-025-00442-5","DOIUrl":"https://doi.org/10.1186/s40780-025-00442-5","url":null,"abstract":"<p><strong>Introduction: </strong>While direct-acting antivirals (DAA) are effective treatment for hepatitis C virus (HCV) patients, concerns about drug-drug interactions (DDIs) remain a significant challenge. Although there are several studies investigating the risk of DDIs associated with DAA therapy, there is limited research evaluating DDIs of DAA therapy in real-world settings in Japan. We investigated prescription patterns of comedication associated with DDIs risk in HCV patients receiving DAA therapy using a large Japanese database.</p><p><strong>Methods: </strong>This was a descriptive epidemiological study, using the Japanese administrative claims database provided by DeSC Healthcare, Inc. Patients who initiated sofosbuvir/velpatasvir (SOF/VEL) or glecaprevir/pibrentasvir (GLE/PIB) between April 2017 and August 2023 were identified from the data. The primary outcome was DDIs associated with comedications which were assessed based on both Japanese package inserts and the Liverpool HEP Drug Interaction Checker (Liverpool HEP checker).</p><p><strong>Results: </strong>Patients included in this study were 7,338, with 467 prescribed SOF/VEL and 6,871 prescribed GLE/PIB. The mean age of the patients was 69.9 years (SD = 13.1), with 50% being male. The median number of comedications was higher in the SOF/VEL group (14.0; IQR = 14.0) than in the GLE/PIB group (9.0; IQR = 12.0) and based on package insert and Liverpool HEP checker, the DDI risk was present in 59.3% (277) of the SOF/VEL group and 51.5% (3,542) of the GLE/PIB group. DDI risk involving two or more medications in combination with a DAA was 14.1% (66) in the SOF/VEL group and 24.0% (1,648) in the GLE/PIB group. In terms of DDI severity, in the SOF/VEL group there were no patients identified under the level \"Contraindication (Red)\" category, indicating medications that do not co-administered, in contrast with the 1.7% (115) in the GLE/PIB group who were identified as \"contraindication (red)\".</p><p><strong>Conclusion: </strong>A considerable proportion of patients were prescribed medications with DDI risk during DAA treatment. A small but notable proportion of patients were on \"Contraindication (Red)\" medications. Consideration of the potential DDI risks associated with comedications by healthcare professionals is advised, referring not only to package inserts but also tools such as Liverpool HEP checker to guide safe prescribing when initiating DAA therapy for HCV patients.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"33"},"PeriodicalIF":1.2,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A preliminary retrospective study of the safety of Vancomycin area under the curve in patients treated with concomitant use of Vancomycin and gentamicin.","authors":"Hirokazu Nakayama, Yoshitsugu Nakamura, Masayo Tanaka","doi":"10.1186/s40780-025-00438-1","DOIUrl":"https://doi.org/10.1186/s40780-025-00438-1","url":null,"abstract":"<p><strong>Background: </strong>Despite numerous studies on safety, acute kidney injury (AKI) caused by vancomycin and/or gentamicin remains a persistent medical issue. However, it remains unclear whether vancomycin AUC below 600 mg·h/L in combination with gentamicin trough level at least below 2 µg/mL are reliable indices to reduce the risk of AKI in patients treated with concomitant vancomycin and gentamicin.</p><p><strong>Objective: </strong>The aim was to elucidate the pharmacokinetic factors associated with AKI development in patients receiving concomitant use of vancomycin and gentamicin in the setting of therapeutic drug monitoring (TDM).</p><p><strong>Methods: </strong>A retrospective study was conducted in 15 patients treated with concomitant vancomycin and gentamicin with TDM. The patients were classified into AKI group and no-AKI group. Vancomycin area under the curve (AUC), gentamicin trough levels, and duration of concomitant duration of vancomycin and gentamicin were investigated.</p><p><strong>Results: </strong>Six (40%) of 15 patients developed AKI during the study period. In AKI group (n = 6), vancomycin AUC was significant higher [median (range) 561 (543‒712) mg·h/L compared to no-AKI group (n = 9), 380 (185‒600) mg·h/L, p = 0.026)], although no significant differences in gentamicin trough level and duration of concomitant vancomycin and gentamicin treatment were found between the two groups. Receiver operating characteristic analysis showed that the best cut-off vancomycin AUC for predicting AKI was 523 mg·h/L, with AUC of 0.852, sensitivity of 1.000 and specificity of 0.778 (p = 0.025).</p><p><strong>Conclusions: </strong>In patients treated with concomitant vancomycin and gentamicin with trough level below 1-2 µg/mL, vancomycin AUC 530 - 600 mg·h/L is associated with AKI risk.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"32"},"PeriodicalIF":1.2,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal metabolic alkalosis and mild diuresis resulting from torasemide self-medication by the mother: a case report.","authors":"Yumi Kitahiro, Mari Hashimoto, Yukako Sonda, Miki Yagi, Kotaro Itohara, Takumi Kido, Kazumichi Fujioka, Hitomi Imafuku, Tomohiro Omura, Ikuko Yano","doi":"10.1186/s40780-025-00436-3","DOIUrl":"https://doi.org/10.1186/s40780-025-00436-3","url":null,"abstract":"<p><strong>Background: </strong>Torasemide, a loop diuretic, is rarely used for pregnant women because of the risk of reduced placental blood flow resulting from decreased circulating plasma volume. We experienced a case of a newborn with metabolic alkalosis and mild polyuria. The mother was suspected of self-medicating as we detected torasemide in the neonatal serum by LC-MS/MS method.</p><p><strong>Case presentation: </strong>A Japanese pregnant woman in her 20s with mental illness, symptoms of panic and eating disorders, and a history of overdosing on over-the-counter medications, was referred to our hospital for birth control. She presented with vomiting following bulimia nervosa and hypokalemia. Her baby was delivered vaginally at 36 weeks and 4 days of gestation. The baby's blood gas analysis on day 0 revealed metabolic alkalosis (pH > 7.42, HCO₃^- > 28 mmHg). Up to 16 h after birth, mild polyuria and a urine output of 3.3 mL/kg/h were observed without the administration of diuretics. We suspected diuretic intake by the mother before delivery, because she had a history of taking torasemide before being referred to the hospital. As expected, torasemide was detected in the baby's serum. The serum concentration on the first day after delivery (4.80 ng/mL) gradually decreased to 0.45 ng/mL on day 5, whereas torasemide was not detected in the maternal serum. Neonatal metabolic alkalosis improved by day 3 following birth.</p><p><strong>Conclusions: </strong>This case suggests close counseling and monitoring of pregnant women before childbirth regarding their past and present use of drugs, particularly in those with mental illness.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"31"},"PeriodicalIF":1.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying characteristics of patients requiring proactive pharmaceutical interventions in the recovery period and assessing the effect of rehabilitation and drugs: a retrospective study.","authors":"Megumi Yahara-Hotta, Tomoyuki Ogino, Kisako Higa, Moka Yamakawa, Toshiyuki Shikata, Yoshihiro Kanata, Kenji Ikeda, Atsushi Kinoshita","doi":"10.1186/s40780-025-00435-4","DOIUrl":"10.1186/s40780-025-00435-4","url":null,"abstract":"<p><strong>Background: </strong>The aging of the population in many countries has made rehabilitation an essential part of improving the quality of life of older individuals. The risk factors for falls during rehabilitation include a history of falls, gait disturbances, dizziness, and medication use. Although numerous studies have explored various fall prevention measures, stratified or detailed analyses of the relationship between the activities of daily living (ADL) and drugs have not been performed. This study aimed to examine the effect of drugs on ADLs in patients undergoing rehabilitation and explored the factors affecting patients' ADLs identify the characteristics of patients requiring proactive pharmaceutical interventions.</p><p><strong>Methods: </strong>Participants aged ≥ 20 years admitted to the Kaifukuki Rehabilitation Ward at Hyogo Medical University Sasayama Medical Center underwent functional independence measure (FIM) assessments and were evaluated for medication use. The complexity of the medication regimen was assessed using the Japanese version of the medication regimen complexity index (MRCI-J) based on prescription data. Hierarchical cluster analysis was used to classify the participants based on their FIM scores.</p><p><strong>Results: </strong>No correlation was found between FIM motor gain and MRCI-J differences among all participants. Hierarchical cluster analysis was used to classify participants into four groups based on their FIM motor and cognitive scores at admission and discharge. Decision tree analysis was performed using the four identified groups as objective variables and yielded eight nodes. The algorithm included length of hospital stay, sex, age, units of rehabilitation performed, and the MRCI-J score. The group with a hospital stay < 74 days, aged < 90 years, and who underwent > 77 units of rehabilitation during the study period was further divided into fourth tiers based on the MRCI-J scores, with the non-increased MRCI-J group assigned as Node 7 and the increased MRCI-J group as Node 8.</p><p><strong>Conclusions: </strong>No relationship was found between ADLs and prescribed drugs in the overall participant population. In participants from Nodes 7 and 8, who had a relatively short length of hospital stay and were discharged with preserved physical and cognitive functions, prescription changes appeared to have some effects on patient's ADLs.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"29"},"PeriodicalIF":1.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11978153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bisphosphonate compliance in Japan from the perspective of product, formulation, and patient characteristics: analysis of medical insurance claim data.","authors":"Kenji Kabeya, Hiroki Satoh, Natsuyo Yanagi, Yasufumi Sawada","doi":"10.1186/s40780-025-00434-5","DOIUrl":"10.1186/s40780-025-00434-5","url":null,"abstract":"<p><strong>Background: </strong>Bisphosphonates are the mainstay drugs for osteoporosis, but in clinical practice, they are often ineffective due to low compliance. However, there have been few studies examining compliance on a product-by-product basis or in detail in Japan. This study aimed to clarify the bisphosphonate compliance from the viewpoints of product selection, formulation, and patient characteristics using medical insurance claim data in Japan, to generate useful knowledge for improving bisphosphonate compliance.</p><p><strong>Methods: </strong>Bisphosphonate records for osteoporosis treatment were extracted from Japanese medical insurance claim data (2021-2023), and the Medication Possession Ratio (MPR) of each patient was calculated from the records. The calculated MPR and compliance classification (Compliant/Non-compliant/Dropout) based on dispensing status were statistically analyzed from viewpoints of drug product, dose form/frequency, and patient sex/age to investigate the influence of each factor on compliance.</p><p><strong>Results: </strong>The mean MPR for all patients (N = 63,197) was 76.7%. Product choice influenced compliance, with significance in 230 pairs among the 71 major products. Tablet was the most compliant formulation, and compliance was better with longer dose intervals. Women showed significantly better compliance and older age was associated with better compliance.</p><p><strong>Conclusions: </strong>This study generated new data regarding product-specific MPRs, and clarified that product selection influences patient compliance. The study also supported previous findings that sex, age, and dose frequency influence compliance. It is expected that the findings of this study will be utilized for drug development, drug selection and patient guidance in clinical practice, to improve the treatment environment for osteoporosis.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"30"},"PeriodicalIF":1.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing adherence, exposure, and toxicity in oral anticancer therapies.","authors":"Kazuo Kobayashi","doi":"10.1186/s40780-025-00437-2","DOIUrl":"10.1186/s40780-025-00437-2","url":null,"abstract":"<p><p>The management of adherence, exposure risk, and adverse effects in oral anticancer agents (OAAs) is essential for optimizing patient outcomes in oncology pharmacy. This review highlights key efforts to enhance adherence, reduce occupational exposure, and improve adverse effect management in OAA therapy.(1) Adherence management.We evaluated adherence to trifluridine/tipiracil hydrochloride (TFTD) in metastatic colorectal cancer (mCRC) patients, revealing an overall adherence rate of 85.0%. Common factors affecting adherence included nausea, vomiting, and cancer-related pain. Pharmacist-led interventions, including antiemetic therapy and patient education, significantly improved compliance.(2) Exposure risk management.A study on spill kit usage found that 91.7% of incidents involved nurses, with most spills occurring in hospital wards. Following a medical safety workshop, compliance with personal protective equipment (PPE) protocols improved to 100%. These findings emphasize the need for continuous safety training and enhanced spill management protocols.(3) Adverse effect management.We examined regorafenib-induced adverse effects, particularly hand-foot skin reaction (HFSR) and hypothyroidism. HFSR occurred in 81.4% of patients, with severe cases (≥ Grade 2) associated with prolonged survival. Routine thyroid function monitoring was essential, as 42.8% of patients developed thyroid dysfunction, with 5.7% requiring hormone replacement therapy. Early intervention and supportive care strategies improved treatment tolerability.This review underscores the importance of pharmacist-driven interventions in enhancing adherence, ensuring occupational safety, and managing adverse effects. Continued research and collaboration are essential to optimize OAA-based therapy and improve patient care in oncology pharmacy.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"28"},"PeriodicalIF":1.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11978023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of statin intervention on peripheral neuropathy in patients treated with anticancer drugs identified from the insurer database.","authors":"Fuka Aizawa, Kenta Yagi, Maki Sato, Takahiro Niimura, Mitsuhiro Goda, Yuki Izawa-Ishizawa, Keisuke Ishizawa","doi":"10.1186/s40780-025-00428-3","DOIUrl":"10.1186/s40780-025-00428-3","url":null,"abstract":"<p><strong>Background: </strong>Statins, hydroxymethylglutaryl-CoA reductase inhibitors, possess neuroprotective properties. Given the potential neuroprotective properties of statins and their prevalent use in clinical settings, we aimed to investigate their impact on chemotherapy-induced peripheral neuropathy (CIPN) in Japan by assessing both their safety and efficacy in this context.</p><p><strong>Methods: </strong>We conducted a retrospective observational study using the Japan Medical Data Centre database, which includes data from 2005 to 2021. We included patients who underwent anticancer therapy and were categorized into non-statin (10,920) and statin (1,537) groups. These groups were matched using a propensity score, resulting in 2,548 non-statin and 1,274 statin users. The primary endpoints were the incidence of CIPN post-first prescription of each anticancer drug and overall survival.</p><p><strong>Results: </strong>Treatment with statins did not increase the incidence of CIPN (non-statin 27.2% vs. statin 28.4%, P = 0.443). Nevertheless, the incidence of CIPN was significantly high among women (non-statin 28.0% vs. statin 33.2%, P = 0.025). Overall survival was not impacted by statin use (hazard ratio 0.98, 95%CI: 0.83-1.16, P = 0.8846). Among men treated with paclitaxel, we observed an improvement in overall survival (hazard ratio: 0.72; 95% CI: 0.56-0.92; P = 0.0110).</p><p><strong>Conclusions: </strong>The use of statins in patients with cancer was not associated with CIPN incidence. However, in men receiving paclitaxel treatment, statins may be linked to improved overall survival. Further studies are necessary to clarify the factors influencing prognosis and CIPN severity.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"27"},"PeriodicalIF":1.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11978124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinical decision support system promotes the appropriate use of drugs in hospitalized patients with kidney impairment.","authors":"Akihiro Sonoda","doi":"10.1186/s40780-025-00431-8","DOIUrl":"10.1186/s40780-025-00431-8","url":null,"abstract":"<p><p>The number of individuals with chronic kidney disease (CKD) is increasing worldwide, including in Japan. Patients with advanced CKD are at an increased risk of serious adverse drug events associated with hospitalization, life-threatening complications, and death.It is necessary to adjust the dosage of renally excreted drugs according to kidney function in patients with CKD. In addition, elderly patients and those with impaired kidney function are also at high risk of drug-induced nephrotoxicity due to nephrotoxic drugs, and special attention should be paid to changes in kidney function before and after administration. Hospitalized patients are more susceptible to acute kidney injury than outpatients, and care must be taken when administering renally excreted or nephrotoxic drugs. Clinical decision support systems (CDSSs) play an important role in preventing overdosage of renally excreted drugs and avoiding the inappropriate use of nephrotoxic drugs. This review discussed the effectiveness, issues, and potential of CDSSs for physicians' prescriptions and pharmacists' prescription audits before hospitalized patients with kidney impairment are administered renally excreted drugs or nephrotoxic drugs, and the follow-up of patients receiving them. Although inappropriate prescriptions of renally excreted drugs due to alerts to prescribers were reduced, prescribers may have ignored interruption alerts. Therefore, the acceptance rate of alerts by prescribers can be improved by minimizing interruptions to the prescriber workflow, specifying only high-severity alerts, and automatically inputting the dosage, administration frequency, and administration duration according to kidney function when the prescriber selects a drug when entering a prescription. Prescription audits by pharmacists using electronic alerts from the CDSS and dosage confirmation sheets were effective in preventing overdosing of renally excreted drugs. In addition, pharmacist interventions for patients at risk of acute kidney injury (AKI) using CDSS alerts may be useful in preventing a decrease in kidney function and the onset of AKI due to nephrotoxic drugs. Although the usefulness of CDSSs may be further improved in the future, further evaluation and improvement of CDSSs are required.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"26"},"PeriodicalIF":1.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: The impact of a heart failure management protocol based on a hospital-community pharmacist collaboration.","authors":"Junichi Terashima, Takahiro Kambara, Eisei Hori, Masahiro Fukatsu, Yukina Ichiki, Eri Oki, Risako Koketsu, Rika Taguchi, Suzuka Mii, Ryoka Hiro, Teruhiro Sakaguchi, Hiroyuki Osanai, Tomoya Tachi, Tadashi Suzuki","doi":"10.1186/s40780-025-00433-6","DOIUrl":"10.1186/s40780-025-00433-6","url":null,"abstract":"","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"25"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and clinical characteristics for Stenotrophomonas maltophilia infection in an acute care hospital in Japan: a single-center retrospective study.","authors":"Michiya Tanuma, Takayuki Sakurai, Hidemasa Nakaminami, Masayo Tanaka","doi":"10.1186/s40780-025-00429-2","DOIUrl":"https://doi.org/10.1186/s40780-025-00429-2","url":null,"abstract":"<p><strong>Background: </strong>Stenotrophomonas maltophilia (S. maltophilia) is a Gram-negative pathogen that causes opportunistic infections. Although the mortality rate among patients with nosocomial infections caused by S. maltophilia is high, the risk factors for infection vary among studies. Moreover, S. maltophilia is highly resistant to several classes of antimicrobial agents. To date, few studies on S. maltophilia have been conducted in Japan, and the details remain unclear. Therefore, the objective of this study was to investigate the risk factors associated with S. maltophilia infection and the antimicrobial susceptibility of S. maltophilia isolates identified in our hospital.</p><p><strong>Methods: </strong>In this study, we investigated the risk factors associated with S. maltophilia infection and clinical characteristics isolated from patients at the NTT Medical Center Tokyo (Tokyo, Japan). We retrospectively examined the S. maltophilia isolates and the corresponding patients between March 2022 and August 2023.</p><p><strong>Results: </strong>Fifty-eight patients with S. maltophilia isolated (median age, 80.5 years; age range, 49-100 years; 70.7% male) were enrolled in this study. Twelve cases (20.7%) were placed in the S. maltophilia infection group and 46 cases were placed in the S. maltophilia colonization group. Central venous (CV) catheterization and higher Sequential Organ Failure Assessment (SOFA) scores were identified as risk factors for S. maltophilia infection. In addition, the 30-day mortality rate was significantly higher, and the survival rate was significantly lower in patients with S. maltophilia infection. The antimicrobial susceptibility rates of S. maltophilia were as follows: 28.6% for ceftazidime, 2.4% for cefozopran, 96.6% for levofloxacin, 100% for minocycline, and 98.3% for trimethoprim-sulfamethoxazole.</p><p><strong>Conclusions: </strong>In actual clinical practice, S. maltophilia was more frequently isolated from sputum. However, most of the cases were colonization, and cases of infection were rare. Early treatment initiation should be considered for S. maltophilia infection in cases where the pathogen is detected from sterile sites, such as blood cultures and pleural fluid or from sputum in cases with a high SOFA score and CV catheter insertion.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"24"},"PeriodicalIF":1.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}