Journal of Pharmaceutical Health Care and Sciences最新文献

{"title":"Pharmaceutical needs at temporary dispensing sites in Suzu City during the subacute phase after the 2024 Noto Peninsula Earthquake: a cross-sectional study of disaster prescription trends.","authors":"Yukari Koike, Shuji Yamashita, Natsuki Umiji, Aina Kano, Aoi Koketsu, Yuka Nakasato, Momoka Yamashita, Nobuhiro Namaki, Masako Hashimoto, Akihiro Watanabe, Taihei Yamada, Hideki Hayashi","doi":"10.1186/s40780-026-00563-5","DOIUrl":"10.1186/s40780-026-00563-5","url":null,"abstract":"<p><strong>Background: </strong>This study examined pharmaceutical needs in the subacute phase following the 2024 Noto Peninsula Earthquake, using dispensed prescriptions as a proxy. We described demand patterns, the dispensing timeline amid early shortages, and the alignment between observed requirements and four disaster medicine lists.</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional analysis of prescriptions dispensed in disaster-affected areas of Japan (primarily Suzu City) between January 7 and 13, 2024. A total of 236 prescriptions were included and categorized into major therapeutic classes. We separated regular prescriptions from as-needed (pro re nata, PRN) prescriptions. The dispensing interval was defined as the number of days from prescription issuance to dispensing. Coverage was calculated by comparing dispensed medicines against four disaster medicine lists, including the Japanese Medical Association Team (JMAT) Carry-on Medicine List.</p><p><strong>Results: </strong>Cardiovascular, central nervous system, and gastrointestinal drugs were the most commonly prescribed medicines. Early shortages delayed dispensing until wholesale supplies resumed on January 11. Regular and PRN prescriptions accounted for 41.9% and 53.8% of all prescriptions, respectively. However, PRN prescriptions were dispensed in fewer days. Coverage of the four disaster medicine lists ranged from 41.8% to 65.9%, with the highest coverage for the JMAT Carry-on Medicine List.</p><p><strong>Conclusions: </strong>This study clarified the characteristics of pharmaceutical needs in Suzu City during the subacute phase, albeit within a limited scope based on the activities of specific medical support teams. Observed pharmaceutical requirements only partially overlapped with existing lists. Portable medicine lists, regional stockpiles, and local formularies tailored to community needs could improve responsiveness. Interim measures, such as temporary services and mobile support, helped bridge the gap in medicine access before supply chain recovery. In this setting, mobile pharmacy vehicles potentially played a central role until normal distribution resumed. These data can inform future disaster medicine planning.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13112765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474097","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":"Clinical assessment of blood glucose responses to 300-mg dose of L-theanine, an amino acid unique to green tea, in a fixed-sequence, two-period trial.","authors":"Shinnosuke Yamaura, Koichi Kawada, Kyosuke Uno, Reiko Konishi, Akira Mukai, Satoshi Tada, Hitoshi Okada, Takashi Majima, Koji Komori, Nobuyuki Kuramoto, Kou Kawada","doi":"10.1186/s40780-026-00562-6","DOIUrl":"10.1186/s40780-026-00562-6","url":null,"abstract":"<p><p>BACKGROUND: L-theanine (N-ethyl-γ-glutamine), an amino acid found in tea leaves and known for contributing to their umami taste, is widely marketed as a supplement for promoting relaxation. Recently, potential effects on blood glucose regulation have been reported. This study evaluated the effect of oral L-theanine intake on blood glucose levels using an oral glucose tolerance test (OGTT) in healthy adults. METHODS: Healthy adult participants ingested 300 mg of L-theanine 15 min before the OGTT. Blood glucose levels were measured at 0 (baseline), 30, 60, 90 and 120 min after the start of the OGTT. A fixed-sequence, two-period trial was conducted: at Visit 1 (pre-intervention), the OGTT was performed without L-theanine, whereas at Visit 2 (intervention), the participants ingested 300 mg of L-theanine before undergoing the OGTT. In addition to blood samples, urine samples were collected whenever the participants felt the need to void and analyzed for glucose, sodium ions, and amino acids. RESULTS: Thirty-nine healthy adults participated in the study. Although blood glucose levels tended to be lower at Visit 2 than at Visit 1, there was no statistically significant difference in the primary endpoint, defined as the difference between the peak glucose level and baseline. Thirty minutes after the start of the OGTT, corresponding to the time when serum L-theanine reached its peak, urinary glucose excretion tended to be higher and urinary sodium ions tended to be lower at Visit 2, although the difference was not statistically significant. Urinary excretion of glutamic acid, aspartic acid, and several other amino acids significantly increased during Visit 2. DISCUSSION: L-theanine may exert a glucose-lowering effect through previously reported mechanisms; however, the effect observed in this study was extremely small and unlikely to raise clinical concerns. Further research is required to clarify the potential effects of long-term L-theanine consumption. </p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13113039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474076","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":"Drug-specific risks of acute kidney injury associated with triple whammy therapy: a nationwide self-controlled case series study in Japan.","authors":"Yuki Kunitsu, Rina Abe, Keiko Ikuta, Daiki Hira, Shunsaku Nakagawa, Masahiro Tsuda, Tomohiro Terada","doi":"10.1186/s40780-026-00560-8","DOIUrl":"10.1186/s40780-026-00560-8","url":null,"abstract":"<p><p>BACKGROUND: Concomitant use of renin–angiotensin system inhibitors (RASIs), diuretics, and nonsteroidal anti-inflammatory drugs (NSAIDs), commonly referred to as the “triple whammy” (TW), is known to increase the risk of acute kidney injury (AKI). However, the relative contribution of each drug component and the influence of their pharmacological subclasses remain unclear. METHODS: A self-controlled case series (SCCS) study was conducted in Japan using a nationwide claims database (April 2014 to January 2024). Patients with at least one AKI episode (the International Classification of Diseases, 10th Edition code N17X) and prescriptions for RASIs, diuretics, or NSAIDs were included. The incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for AKI were estimated using conditional Poisson regression to compare the exposed and unexposed periods within individuals. Sensitivity analyses accounted for the time-varying nephrotoxic exposure to antibiotics, antiviral agents, and iodinated contrast media. RESULTS: Among the 92,880 eligible patients, 109,351 AKI events occurred during 129 million person-days of follow-up. The risk of AKI increased with the number of concomitant drug classes used. Concomitant use of two drug class combinations, that is, diuretics and NSAIDs, conferred the greatest risk, and during TW exposure, the risk was not significantly higher than that observed with diuretics and NSAIDs (IRR 1.01 [0.86–1.19]). The risk of AKI increased with both the number and type of diuretics used, with loop diuretics demonstrating the highest risk. No significant differences were found between angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers, and the higher AKI risk observed with nonselective COX inhibitors compared with COX-2-selective agents disappeared after adjustment for time-dependent covariates. CONCLUSIONS: In this nationwide SCCS study, the AKI risk associated with TW therapy was primarily driven by the concomitant use of diuretics and NSAIDs, rather than RASIs. The risk varied according to the number and type of diuretics used, emphasizing the importance of cautious prescription and close renal monitoring during periods of combined use of diuretics and NSAIDs. </p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13081389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372829","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":"Modifying effect of hospital size on the impact of antimicrobial stewardship programs for methicillin-resistant Staphylococcus aureus bloodstream infections: a nationwide claims database analysis.","authors":"Keisuke Sawada, Ryo Inose, Yuichi Muraki","doi":"10.1186/s40780-026-00558-2","DOIUrl":"10.1186/s40780-026-00558-2","url":null,"abstract":"<p><p>BACKGROUND: The effectiveness of antimicrobial stewardship programs may vary by institutional context. We evaluated whether hospital size modifies the impact of nationally incentivized antimicrobial stewardship programs on clinical and economic outcomes in patients with methicillin-resistant Staphylococcus aureus bloodstream infections. METHODS: This retrospective cohort study analyzed Japanese nationwide claims data from 2018 to 2022. We compared outcomes between adult inpatients with methicillin-resistant Staphylococcus aureus bloodstream infections in large (≥ 500 beds) versus non-large (< 500 beds) hospitals using 1:1 propensity score matching. The primary outcome was time to discharge. We used an interaction term to assess effect modification by hospital size on the association between antimicrobial stewardship programs and outcomes. RESULTS: The matched cohort included 926 patients (463 pairs). At baseline, average daily total antimicrobial costs were significantly higher in large hospitals (rate ratio 1.32, 95% CI 1.16–1.50). Hospital size significantly modified the association between antimicrobial stewardship programs and time to discharge (P for interaction = 0.01). In non-large hospitals, antimicrobial stewardship programs were associated with significantly shorter time to discharge (hazard ratio 0.31, 95% CI 0.13–0.75). In large hospitals, antimicrobial stewardship programs were not associated with time to discharge but were associated with significantly reduced average daily antipseudomonal drug costs (rate ratio 0.46, 95% CI 0.30–0.71). CONCLUSIONS: Hospital size modified the association between antimicrobial stewardship program fee acquisition and outcomes among patients with methicillin-resistant Staphylococcus aureus bloodstream infections. In non-large hospitals, antimicrobial stewardship program fee acquisition was associated with shorter time to discharge, whereas in large hospitals, it was primarily associated with changes in prescribing patterns. These findings suggest that stewardship evaluation and policy should be tailored to institutional characteristics. </p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13041119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147306881","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":"Nudge-based patient education by pharmacists to promote self-care behaviors for preventing and mitigating chemotherapy-induced skin toxicity: rationale, design, and study protocol of the PHARM-NUDGE trial.","authors":"Yuka Ito, Koji Suzuki, Masahiro Hatori, Takahiko Yagi, Yasunori Miyamoto, Hikaru Sato, Shuichi Watabe, Naoki Shibata, Yume Otsuka, Tatsuya Yagi, Junichi Kawakami","doi":"10.1186/s40780-026-00556-4","DOIUrl":"10.1186/s40780-026-00556-4","url":null,"abstract":"<p><strong>Background: </strong>Nudge strategies are well-established in behavioral economics as effective approaches for promoting desirable behaviors. However, the potential benefits of integrating nudge-based strategies into pharmacist-led patient education have not yet been demonstrated. Here, we present a study protocol for an interventional trial to address this issue.</p><p><strong>Methods: </strong>The PHARM-NUDGE study is a multicenter, randomized, parallel-group, single-blind, controlled trial prospectively designed to evaluate whether nudge-based pharmacist-led education can promote patients' preventive behaviors against skin toxicities associated with cancer chemotherapy. The key inclusion criteria are as follows: (1) patients who are men or women and aged 18 years or older and (2) patients scheduled to receive a chemotherapy regimen containing capecitabine, liposomal doxorubicin, lenvatinib, cetuximab, or panitumumab in outpatient chemotherapy units or during hospitalization. The enrolled patients are randomly assigned in a 2:1 ratio to the nudge-based education or standard education groups. Pharmacists responsible for patient education utilize special educational tools that incorporate nudge strategies and provide skincare education to patients assigned to the nudge-based education group. Patients assigned to the standard education group receive skincare education with equivalent content but without nudges. The primary endpoint is the proportion of patients in each group who achieve four or more of the five predefined behavioral criteria.</p><p><strong>Conclusions: </strong>The PHARM-NUDGE study is the first randomized controlled trial to evaluate the potential benefits of integrating nudge strategies into pharmacist-led skincare education for patients undergoing cancer chemotherapy with a high risk of skin toxicity, with patient enrollment initiated on October 15, 2025. Completion of the trial and acquisition of the final results are eagerly anticipated.</p><p><strong>Trial registration: </strong>This trial was registeredwith the Japan Registry of Clinical Trials (clinical trial number: jRCT1040250089, registration date: September 3, 2025).</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13032257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776187","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":"The effect of ondansetron intravenous administration to caloric intake for patients of gynecological surgery.","authors":"Eiji Horita, Mitsuo Kaneshima, Yasuhisa Kobayashi, Masaki Sano, Yoshie Takebayashi, Kenichiro Saito, Yoshinori Munemoto, Kazuko Mitsuya, Hiroyuki Satomi, Kumiko Hosokawa, Tetsuji Kurokawa, Koichi Shimo, Satoshi Shine","doi":"10.1186/s40780-026-00557-3","DOIUrl":"10.1186/s40780-026-00557-3","url":null,"abstract":"<p><strong>Background: </strong>Postoperative nausea and vomiting can be a serious issue in reducing caloric intake for patients in the early stage after surgery. In Japan, ondansetron injection is now approved by insurance as a countermeasure against postoperative nausea and vomiting, but the number of reports on its effects regarding caloric intake is limited in the early stage following surgery, and opinions about the effects are divided. Thus, we examined how the effects of ondansetron administration during surgery influence caloric intake starting the day after surgery.</p><p><strong>Methods: </strong>We examined 65 patients who received a 4mg injection of ondansetron during gynecological surgery under epidural anesthesia, in comparison to 51 patients who did not receive any antiemetic. Our study was to compare the amount of caloric intake the day after surgery.</p><p><strong>Results: </strong>The patient group who received an ondansetron injection showed higher caloric intake (1364.1 ± 55.9 vs 1188.3 ± 63.1 kcal; ANCOVA, p = 0.045). A significant increase in caloric intake was observed in patients with an Apfel Score of 3 (807 ± 62 vs 593 ± 76 kcal; p = 0.031).</p><p><strong>Conclusions: </strong>Our study indicated that ondansetron administration during gynecological surgery may have a positive effect on increasing postoperative caloric intake one day after surgery.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13032205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258545","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":"Relationship of nutritional or systemic inflammatory markers with efficacy of gemcitabine and cisplatin with or without durvalumab therapy for patients with unresectable or metastatic biliary tract cancer: a retrospective study.","authors":"Yayoi Fukushi, Kazuma Fujita, Yumiko Akamine, Haruka Igarashi, Katsuya Sasaki, Koji Fukuda, Hiroyuki Shibata, Masafumi Kikuchi","doi":"10.1186/s40780-026-00555-5","DOIUrl":"10.1186/s40780-026-00555-5","url":null,"abstract":"<p><p>BACKGROUND: Nutritional or systemic inflammatory markers like modified Glasgow Prognostic Score (mGPS), prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are useful prognostic indicators, but their role in patients with unresectable or metastatic biliary tract cancer receiving gemcitabine plus cisplatin (GC) or GC plus durvalumab is unclear. This study investigates the relationship of these markers with treatment outcomes and survival. METHODS: Chemotherapy consisted of protracted infusion of gemcitabine (1000 mg/m2/day) and cisplatin (25 mg/m2/day) on day 1 and 8, or gemcitabine (1000 mg/m2/day), cisplatin (25 mg/m2/day) on day 1 and 8 and durvalumab (1500 mg/day 1) given once every 21 days. After six cycles of GC plus durvalumab therapy, durvalumab monotherapy was administered at 1500 mg every 4 weeks. PNI, NLR, PLR and mGPS were assessed before treatment using established cutoffs. Overall survival (OS) and time to treatment failure (TTF) were analyzed with Kaplan–Meier and Cox regression models. The primary endpoint was OS, defined as the time from the start of chemotherapy to death. RESULTS: This study analyzed 103 patients with unresectable or metastatic biliary tract cancer treated with GC or GC plus durvalumab. For patients with PLR ≥ 148 the median survival was 13.7 months and for those with PLR < 148 the median OS was not estimated; this difference was significant (p = 0.016). For patients with mGPS 0–1 and 2 the median OS was 16.9 months and 7.9 months, respectively, and this difference was also significant (p < 0.001). Univariate analysis revealed that, among the nutritional or systemic inflammatory markers tested, mGPS 2 and PLR ≥ 148 significantly predicted shorter OS. Multivariate analysis further confirmed that mGPS 2 is an independent risk factor for shorter OS. CONCLUSION: A mGPS of 2 was a predictor of shorter OS for patients with unresectable or metastatic biliary tract cancer receiving GC or GC plus durvalumab. Evaluating mGPS prior to treatment initiation may support planning of individualized treatments that can enable clinicians to identify patients who are likely to benefit from chemotherapy and to exercise caution when considering systemic therapy for those with mGPS 2. </p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207222","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":"Investigation of a simple suspension method for orexin receptor antagonist tablets.","authors":"Kazuhiro Hada, Daichi Inoue, Kouyou Ohishi, Toshiya Yasunaga, Kayoko Ozeki, Hiromitsu Yamamoto, Nobuhiko Nakamura","doi":"10.1186/s40780-026-00553-7","DOIUrl":"10.1186/s40780-026-00553-7","url":null,"abstract":"<p><p>BACKGROUND: A simple suspension method is used in medical practice to administer several orexin receptor antagonists for patients with dysphagia; however, detailed suspension and passage through catheter evaluations have not been performed. Therefore, to safely administer orexin receptor antagonists using the simple suspension method in patients with dysphagia, this study evaluated the disintegration, suspension, passage through the catheter, and drug recovery after passage of Belsomra® 20 mg (suvorexant), Dayvigo® 10 mg (lemborexant), and Quviviq® 50 mg (daridorexant) tablets through a catheter. METHODS: Disintegration and suspension of Belsomra® 20 mg, Dayvigo® 10 mg, and Quviviq® 50 mg tablets, and passage through the catheter were visually confirmed. Drug recovery after passage through the catheter was quantified using liquid chromatography-mass spectrometry. RESULTS: In this study, there was no disintegration and suspension of Belsomra® 20 mg tablets. However, Dayvigo® 10 mg and Quviviq® 50 mg tablets demonstrated disintegration and suspension, including passage through the catheter after rapid and complete disintegration. Drug recovery after catheter passage was >80% for Dayvigo® 10 mg without flushing and for Quviviq® 50 mg after two flushes. CONCLUSION: As the disintegration and suspension properties of Belsomra® 20 mg tablet could not be confirmed, the conventional simple suspension method is not suitable for this product. However, Dayvigo® 10 mg and Quviviq® 50 mg tablets showed potential suitability for the simple suspension method. </p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13011777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197822","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 factor analysis for ceftriaxone-associated liver dysfunction in older patients.","authors":"Tomohiko Tagashira, Ryoya Odawara, Naohito Suga, Rikako Nakamura, Makoto Tagashira, Kohei Minematsu","doi":"10.1186/s40780-026-00554-6","DOIUrl":"10.1186/s40780-026-00554-6","url":null,"abstract":"<p><strong>Background: </strong>Information on ceftriaxone (CTRX)-associated liver dysfunction in older patients remains limited. This study, investigated the risk factors for CTRX-associated liver dysfunction in patients aged ≥65 years.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of the medical records of 105 hospitalized patients aged ≥65 years who received CTRX at Innoshima-Ishikai Hospital. Variables significantly associated with liver dysfunction in univariate analyses were entered into a multivariate logistic regression model to identify independent risk factors. Cutoff values were determined using receiver operating characteristic curve analysis. The incidence of liver dysfunction was compared according to the number of identified risk factors. Fisher's exact test was used for comparisons between groups.</p><p><strong>Results: </strong>In univariate analyses, alanine aminotransferase (ALT) and C-reactive protein (CRP) levels were significantly associated with liver dysfunction (p < 0.05). Multivariate logistic regression identified ALT as an independent risk factor (odds ratio [OR] 1.14; 95% confidence interval [CI]: 1.04-1.24, p = 0.003). CRP was also significantly associated with liver dysfunction, although the effect size was small (OR 1.07; 95% CI: 1.00-1.14, p = 0.043). The optimal cutoff values were 11 U/L for ALT and 5.9 mg/dL for CRP. The incidence of liver dysfunction was 0% in patients with no risk factors, 10.7% in those with elevated ALT only, 8.3% in those with elevated CRP only, and 50% in those with both elevated ALT and CRP. Patients with both risk factors had a significantly higher incidence of liver dysfunction than those in the other groups (p < 0.001).</p><p><strong>Conclusion: </strong>Among patients aged ≥ 65 years, elevated baseline ALT (≥ 11 U/L) and CRP (≥ 5.9 mg/dL) levels were associated with an increased risk of CTRX-associated liver dysfunction. Careful monitoring of liver function during and after CTRX administration is therefore recommended in this population.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":"20"},"PeriodicalIF":1.2,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12903293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165853","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":"Trends in Linezolid Prescription in Japan based on National database open Data: implications for the need for therapeutic drug monitoring.","authors":"Yuichi Muraki, Norio Ohmagari","doi":"10.1186/s40780-026-00552-8","DOIUrl":"10.1186/s40780-026-00552-8","url":null,"abstract":"<p><p>BACKGROUND: Linezolid is an oxazolidinone antibiotic widely used to treat infections caused by resistant Gram-positive bacteria. It has long been regarded as a drug that does not require therapeutic drug monitoring, owing to its limited pharmacokinetic variability. However, recent clinical observations suggest that delayed linezolid elimination is associated with hematological toxicity and thrombocytopenia, particularly in older adults and individuals with reduced renal function. As Japan has a rapidly aging population, understanding real-world linezolid prescription patterns is important for contextualizing potential safety concerns related to its use. METHODS: This study analyzed Japanese national linezolid prescription trends using publicly available data from the National Database of Health Insurance Claims. The annual prescription counts of oral and parenteral linezolid formulations were descriptively examined in inpatient and outpatient settings, along with age- and sex-specific distributions. To provide comparative context, inpatient trends in parenteral use of major anti- methicillin-resistant Staphylococcus aureus (MRSA) agents were also assessed using the same data source. RESULTS: Inpatient use declined steadily from 2014 to 2023. Outpatient use remained extremely limited for most of the study period; however, oral outpatient prescriptions became observable from 2022 onward, though the absolute magnitude remained small. Given that outpatient care generally involves less intensive clinical monitoring, even limited outpatient use warrants careful interpretation. Age-stratified analysis revealed that prescriptions were concentrated among older adults, with the highest use observed in individuals aged 85–89 years. These patients are more likely to have reduced renal function, which can further increase drug exposure and the risk of toxicity. Stratified analyses further demonstrated that outpatient oral use was almost exclusively observed among older adults. In the comparative inpatient analysis of parenteral anti-MRSA agents, trends differed by agent, indicating that the decline in linezolid use did not simply reflect uniform changes in inpatient anti-MRSA antibiotic utilization. CONCLUSIONS: These national prescribing patterns indicate that linezolid continues to be used predominantly among older adults. Although causal relationships cannot be inferred from this descriptive analysis, the findings highlight clinical contexts in which careful monitoring of linezolid therapy may be particularly important. Further evaluation is warranted to determine whether monitoring strategies, including the potential role of therapeutic drug monitoring, could contribute to safer use of linezolid in high-risk patient populations. </p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12924204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165771","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}