Basic & Clinical Pharmacology & Toxicology最新文献

{"title":"Telepharmacological Consultation for Polypharmacy Management in Primary Care: A Qualitative Study of General Practitioners' Experiences With Cross-Sectoral Coordination","authors":"Daniel Pilsgaard Henriksen","doi":"10.1111/bcpt.70325","DOIUrl":"10.1111/bcpt.70325","url":null,"abstract":"<p>The telepharmacological outpatient clinic (TPOC) is a hospital service in which clinical pharmacologists and clinical pharmacists review a patient's full medication regimen and hospital record, then discuss it with the referring general practitioner (GP) by video conference. Seven GPs in the Region of Southern Denmark who had used or been introduced to the service were interviewed to explore how it was used and what prevented wider use. Interviews were semi-structured and analysed thematically. GPs described practices organised around single diagnoses, with no separate pathway for patients who are difficult because they are complex. This was the setting the service entered. Four themes were identified. Whether the service was used depended on integration into existing clinical software. Its value reached past the referred patient, as GPs applied what they had learned to patients never referred. GPs described a coordination gap for patients attending several outpatient clinics, where no clinician held an overview of the whole treatment. They wanted the intensity of the service matched to the complexity of the case. GPs who wanted to refer more often pointed to awareness and time pressure, not to doubts about the service. Uptake appears to depend on workflow integration.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bcpt.70325","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence on Glutathione and Boosters for Prevention of Chemotherapy-Induced Neuropathy: A Systematic Review and Network Meta-Analysis","authors":"Min Jung Geum,&nbsp;Jinyoung Jeon,&nbsp;JinYoung Moon,&nbsp;Hyun Woo Lee,&nbsp;Soyun Kim,&nbsp;Yun Mi Yu,&nbsp;Young-Mi Ah","doi":"10.1111/bcpt.70319","DOIUrl":"10.1111/bcpt.70319","url":null,"abstract":"<div>\u0000 \u0000 <p>Chemotherapy-induced peripheral neuropathy (CIPN) adversely affects treatment efficacy and quality of life. Despite studies on glutathione (GSH) or GSH boosters' antioxidative effects for prevention, optimal management remains uncertain. We conducted a systematic review and network meta-analysis of randomized controlled trials to consolidate and critically appraise the current evidence and to compare the efficacy of GSH and GSH boosters for the prevention of CIPN. The MEDLINE, Embase and CENTRAL databases were searched through March 2025. Twenty-five RCTs involving 1625 patients were included. No intervention significantly reduced all-grade CIPN compared with placebo. <i>N</i>-acetylcysteine (odds ratio [OR] 0.19, 95% credible intervals [CrI] 0.05–0.63), GSH (OR 0.34, 95% CrI 0.13–0.79) and vitamin E (OR 0.33, 95% CrI 0.11–0.91) were associated with a reduced incidence of grade 3/4 CIPN compared with placebo. <i>N</i>-acetylcysteine ranked highest for both all-grade and grade 3/4 CIPN prevention. These findings remained consistent in sensitivity analyses excluding patients with pre-existing neuropathy but were not retained in analyses restricted to double-blind studies. Overall, <i>N</i>-acetylcysteine, GSH, and vitamin E were associated with potential reductions in severe CIPN, with <i>N</i>-acetylcysteine consistently ranking highest, although these associations should be regarded as preliminary. Further rigorously conducted and adequately powered trials are warranted to confirm these findings and evaluate agents demonstrating potential benefits.</p>\u0000 </div>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179150","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":"Serum Concentration Relationships of Candesartan in Migraine Prevention","authors":"Hedda Skogum Riise,&nbsp;Melanie Simpson,&nbsp;Ketil Arne Espnes,&nbsp;Erling Andreas Tronvik,&nbsp;Andreas Kattem Husøy,&nbsp;Lise R. Øie,&nbsp;Anker Stubberud,&nbsp;Emil Kofoed,&nbsp;Aurora Harsvik Alstad,&nbsp;Hedda Hoff Hagen,&nbsp;Maren Guldteig Lien,&nbsp;Marie Larsen Stavseng,&nbsp;Ella Rian Sæther,&nbsp;Tore Wergeland","doi":"10.1111/bcpt.70322","DOIUrl":"10.1111/bcpt.70322","url":null,"abstract":"<p>Migraine is a common disabling disorder, and optimising affordable preventive treatments remains highly relevant. Candesartan is an effective and well-tolerated preventive treatment, but little is known about its dose-concentration–response relationships. We explored these relationships using data from the MigriNor study, a prospective observational cohort of adults with episodic or chronic migraine initiating oral preventive treatment. A total of 166 participants using candesartan were included (median age 35 years; 89% female). Participants completed a daily electronic headache diary during a 4-week baseline and 12-week follow-up period with accompanying blood sampling. Dosing regimen was flexible. No differences in adverse drug reactions (ADRs) or treatment acceptability were observed between participants starting 4 versus 8 mg. Substantial interindividual variability in serum concentrations was observed. Higher serum concentrations were associated with lower odds of headache attacks (OR = 0.97, 95% CI = 0.96–0.98, <i>p</i> &lt; 0.001) and migraine attacks (OR = 0.98, 95% CI = 0.97–0.99, <i>p</i> = 0.005). Interquartile ranges of serum concentrations among ≥ 30% and ≥ 50% responders were 62.9–141.2 and 62.3–129.3 nmol/L, respectively, suggesting preliminary therapeutic reference ranges. Serum concentration was not associated with ADRs or treatment acceptability. Interpretation is limited by the flexible dosing design, and studies with fixed dosing regimens are warranted.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms of XCR1 Membrane Trafficking and Constitutive Endocytosis","authors":"Qiao Li,&nbsp;Fabian Pfersdorf,&nbsp;Fernando Salgado-Polo,&nbsp;Martin Gustavsson","doi":"10.1111/bcpt.70318","DOIUrl":"10.1111/bcpt.70318","url":null,"abstract":"<p>Chemokines orchestrate immune cell trafficking through receptor-mediated signalling and are implicated in inflammatory, autoimmune and neuropathic disorders. The XCL1–XCR1 axis is of particular interest because XCR1 is selectively expressed on mature conventional type 1 dendritic cells (cDC1s), where it supports communication with activated CD8⁺ T cells and NK cells and promotes antigen cross-presentation. This selectivity has made XCR1 an attractive target for dendritic cell–based cancer vaccines, while emerging evidence also links XCL1–XCR1 signalling to neuroinflammation and pain. Despite its therapeutic potential, the mechanisms governing XCR1 activation and trafficking remain understudied. Here, we characterize XCR1 expression, membrane trafficking, and basal internalization to define mechanisms that may influence therapeutic targeting. We show that XCR1 undergoes constitutive internalization through a β-arrestin–independent but adaptor protein 2 (AP2)–dependent pathway, distinguishing it from other chemokine receptors with constitutive endocytosis. Furthermore, we identify specific sequence motifs critical for its subcellular localization and intracellular trafficking. These findings provide new mechanistic insights into XCR1 regulation and may inform the development of targeted therapeutics and antigen-delivery strategies in cancer and inflammation.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating Potential Adverse Drug Reactions of Lisdexamfetamine Using Sequence Symmetry Analysis","authors":"Thomas Leth Jensen,&nbsp;Sanne Møller Thysen,&nbsp;Espen Jimenez-Solem,&nbsp;Anders Jørgensen,&nbsp;Camilla Bjørn Jensen,&nbsp;Hans Kristian Råket,&nbsp;Merete Osler,&nbsp;Mads Nielsen,&nbsp;Lars Christian Lund","doi":"10.1111/bcpt.70316","DOIUrl":"10.1111/bcpt.70316","url":null,"abstract":"<p>The prevalence of ADHD is increasing rapidly, and lisdexamfetamine is increasingly popular, but few studies investigate its safety. We performed a sequence symmetry analysis (SSA) using Danish register data to identify potential ADRs associated with lisdexamfetamine in 2013–2023. Outcomes were incident prescriptions or incident discharge diagnoses. We calculated trend-adjusted sequence ratios (SR) with 95% confidence intervals (CI). We additionally performed two comparator SSAs for the same outcomes following incident use of stimulants (methylphenidate and dexamfetamine) or non-stimulants (guanfacine and atomoxetine). This study is reported according to RECORD-PE guidelines. We included 48 740 incident lisdexamfetamine users with a median age of 24 years (IQR 16–35). SRs were calculated for 1426 exposure–diagnosis and 1337 exposure–prescription pairs. The 50 highest SRs from each category were evaluated. Among these, 28 exposure–outcome combinations had a 95% CI lower bound above 1. Of the 100 outcomes, 33 were considered known ADRs, while 60 were previously unknown. Two outcomes indicating increased urinary symptoms were identified (‘hematuria’, SR: 1.88 [95% CI: 1.25; 2.85] and ‘other urinary symptoms’, SR: 1.63 [1.20; 2.23]). We also identified serious gastrointestinal outcomes as a potential safety alert. Further investigation into these symptoms as potential ADRs is warranted.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bcpt.70316","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D: Physiology, Pharmacology and Clinical Evidence for Supplementation—A Narrative Review","authors":"Jyrki K. Virtanen","doi":"10.1111/bcpt.70315","DOIUrl":"10.1111/bcpt.70315","url":null,"abstract":"<p>Vitamin D is a nutrient and prohormone obtained from diet and supplements and synthesized in the skin. It is essential for calcium and phosphate homeostasis and skeletal health and influences multiple extra-skeletal processes, yet deficiency remains common worldwide. This narrative review summarizes vitamin D sources, physiology, metabolism, pharmacokinetics, clinical relevance and safety and outlines the distinct pharmacokinetic profiles and clinical roles of vitamin D, calcidiol and calcitriol and its analogues. Evidence consistently supports vitamin D, combined with calcium, for preventing and treating deficiency-related skeletal disorders in high-risk populations, and in specific conditions such as malabsorption, chronic kidney disease, hypoparathyroidism and frailty. In vitamin D–replete populations, large trials show limited extra-skeletal benefits, apart from modest effects on cancer mortality and progression from prediabetes to Type 2 diabetes. Untargeted screening is not recommended. Future research should prioritize targeted supplementation, standardized assays and identification of populations most likely to benefit from supplementation.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bcpt.70315","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Doses of N-Acetyl-P-Aminophenol Cause Acute Changes in Electroencephalographic and Electrocardiographic Activities in Wistar Rats","authors":"Alex Luiz Menezes da Silva,&nbsp;Luiz Gustavo dos Reis de Freitas,&nbsp;Akira Otake Hamoy,&nbsp;Clarissa Araujo da Paz,&nbsp;Luan Oliveira Ferreira,&nbsp;Esther Padilha da Silveira,&nbsp;Maria Klara Otake Hamoy,&nbsp;Nilton Akio Muto,&nbsp;Dielly Catrina Favacho Lopes,&nbsp;Moisés Hamoy","doi":"10.1111/bcpt.70321","DOIUrl":"10.1111/bcpt.70321","url":null,"abstract":"<p><i>N</i>-acetyl-<i>p</i>-aminophenol (APAP), or acetaminophen, is the most prescribed analgesic and antipyretic, even used in association with other drugs. Because it is easily bought in drugstores, much evidence about its toxic effects is known due to high doses or continuous use, which can lead to death in cases of intoxication. The present study aimed demonstrate the ability of APAP to change the brain and heart electrical activities, as early as significant increase in liver enzymes. Thus, a toxic dose of 1 g/kg was administered orally, and the animals were assessed every 3 h until 12 h for electroencephalography, electrocardiography and liver function data. The results showed that a toxic dose of APAP was capable of reducing brain electrical activity for the delta, theta, beta and gamma waves; however, the alpha wave activity was increased. In the heart, a reduced electrical activity was observed synchronously with the electroencephalogram. During the 12-h follow-up period, a significant increase in liver enzymes was observed. Taken together, we conclude that high doses of APAP can alter frequency brain oscillations and promote cardiac changes independently of liver damage in the first 12 h.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bcpt.70321","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency of Clinically Relevant Drug–Drug Interactions Between Tyrosine Kinase Inhibitors and Proton Pump Inhibitors in Patients With Cancer Using Real-World Data","authors":"Grietje van Elp,&nbsp;Maikel Borg,&nbsp;Jens H. J. Bos,&nbsp;Catharina C. M. Schuiling-Veninga,&nbsp;Katja Taxis,&nbsp;Frank G. A. Jansman","doi":"10.1111/bcpt.70317","DOIUrl":"10.1111/bcpt.70317","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Proton pump inhibitors (PPIs) raise stomach pH, leading to reduced bioavailability of many tyrosine kinase inhibitors (TKIs), thereby affecting treatment outcomes. To what extent this interaction occurs in clinical practice remains underexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine the frequency of clinically relevant interactions between TKIs and PPIs in clinical practice and the duration of concomitant prescription.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective observational study was performed using the IADB.nl prescription database. Clinically relevant drug–drug interactions between TKIs and PPIs were assessed using four drug compendia (i.e., KNMP Kennisbank, Health Base, Lexidrug and Merative Micromedex). Patients who were prescribed a TKI and PPI with a clinically relevant DDI concomitantly, between 1 January 2013 and 31 December 2024, were included. Concomitant prescription was defined as ≥ 7 days of simultaneous prescription.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>In total, 60 TKIs were registered in the Netherlands; 19 TKIs had clinically relevant interactions reported by at least one compendium. Overall, 393 of 1759 (22.3%) TKI users had a clinically relevant interaction. The median duration of concomitant prescription was 43 days (IQR = 81), with 91.1% of episodes lasting at least 30 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PPIs and TKIs are frequently prescribed concomitantly in clinical practice. Prescribers should be more cautious when co-prescribing PPIs with TKIs and adapt the dosing regimens when appropriate.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone Anabolic Treatment in Patients With Chronic Kidney Disease: A Systematic Review","authors":"Huriye Seyma Kafa,&nbsp;Sabina Chaudhary Hauge,&nbsp;Ditte Hansen","doi":"10.1111/bcpt.70293","DOIUrl":"10.1111/bcpt.70293","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic kidney disease (CKD) associated osteoporosis leads to an increased risk of bone fracture in patients with CKD. Evidence on the efficacy and safety of anti-osteoporotic medications is limited for this group. This systematic review aimed to examine the efficacy and safety of anabolic parathyroid hormone (PTH) treatment in patients with CKD Stages 4–5D.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>MEDLINE, EMBASE and ClinicalTrials.gov were searched systematically for randomized controlled trials (RCTs) investigating teriparatide, natpara, or abaloparatide in adult patients with CKD Stages 4–5D, including kidney transplant recipients. The primary outcome was the change in bone mineral density (BMD) during follow-up measured at the lumbar spine (LS), femoral neck (FN) and total hip (TH). The secondary outcomes included bone turnover markers, fractures, histomorphometric results from bone biopsies and adverse events (AEs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two RCTs were included. A subgroup analysis of patients with CKD Stage 4 (<i>n</i> = 5) showed that teriparatide improved BMD at the LS and FN. Another trial (<i>n</i> = 61) in CKD Stage 5D showed significant BMD improvement at the TH compared to the control group. AEs were observed with higher frequency in the teriparatide-treated group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Treatment with teriparatide seems to improve BMD in patients with CKD Stages 4–5D, but evidence on efficacy and safety is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>PROSPERO: CRD42024527086</p>\u0000 </section>\u0000 </div>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic Use for Cystitis and Risk of Treatment Failure in Pregnancy Following Gastric Bypass: A Cohort Study","authors":"Mette Østergaard Thunbo,&nbsp;Line Kolding,&nbsp;Samuel Azuz,&nbsp;Terese Matthesen Kamronn,&nbsp;Lene Høimark,&nbsp;Lars Henning Pedersen","doi":"10.1111/bcpt.70311","DOIUrl":"10.1111/bcpt.70311","url":null,"abstract":"<p>Cystitis is common during pregnancy and requires effective antibiotic treatment to prevent complications. Gastric bypass surgery alters gastrointestinal anatomy and may impair oral drug absorption, raising concerns about antibiotic effectiveness. We therefore aimed to examine antibiotic use for cystitis and the risk of treatment failure in pregnant women with prior gastric bypass. In this nationwide Danish register-based study, we compared 1985 pregnancies among women with prior gastric bypass with 1 400 174 pregnancies among women without bariatric surgery. We assessed redeemed prescriptions for cystitis-related antibiotics and potential treatment failure defined as repeated antibiotic prescriptions within 14 days, hospital-recorded cystitis or severe urinary tract complications (pyelonephritis or urosepsis). Pregnant women with prior gastric bypass more frequently redeemed cystitis-related antibiotics than those without bariatric surgery (22.6% vs. 12.7%). Among antibiotic-exposed pregnancies, prior gastric bypass was associated with an increased risk of potential treatment failure, including repeated antibiotic prescriptions (adjusted odds ratio [aOR] 1.69, 95% confidence interval [CI] 1.22–2.30) and hospital-recorded cystitis (aOR 2.22, 95% CI 1.24–3.67), while severe complications were rare. These findings suggest that antibiotic treatment may be less effective or that the clinical course is more complicated in this group, highlighting a need for closer monitoring and tailored treatment strategies.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"139 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}