- 著者
- Satoru Mitsuboshi Kazuhiko Nagai Hideo Okajima
- 出版者
- The Pharmaceutical Society of Japan
- 雑誌
- Biological and Pharmaceutical Bulletin (ISSN:09186158)
- 巻号頁・発行日
- vol.43, no.8, pp.1275-1278, 2020-08-01 (Released:2020-08-01)
- 参考文献数
- 16
- 被引用文献数
- 4 4
Although distigmine is known to sometimes cause severe adverse drug reactions (ADRs), such as cholinergic crisis, there are limited data on the risk factors for these ADRs. In this study, we defined a serum cholinesterase (sChE) cutoff level for early detection of ADRs to distigmine and sought to identify risk factors for these ADRs based on this value. This retrospective cohort study included all patients who were prescribed distigmine and underwent measurement of sChE over a period of 8 years at Kaetsu Hospital. Ninety-three patients were included. The sChE cutoff level below which there was an increase in risk of ADRs was defined as 129 U/L based on the levels in patients who had ADRs by receiver operating characteristic analysis. The percentage of ADRs tended to increase with advancing chronic kidney disease (CKD) stage. Multivariate logistic regression analyses showed that a distigmine dose >0.1 mg/kg/d (odds ratio 3.19, 95% confidence interval 1.24–8.19) and age >85 years (odds ratio 3.04, 95% confidence interval 1.18–7.82) were positively associated with an sChE level ≤129 U/L. An sChE cutoff level of 129 U/L is a useful predictor of the risk of an ADR to distigmine, and dose per body weight, age, and CKD progression may pose potential risk of an ADR to distigmine. Therefore, for patients taking distigmine who have these risk factors, the risk of a severe ADR to distigmine can be reduced by decreasing the dose of distigmine and close monitoring of the sChE level.
- 著者
- Satoru Mitsuboshi Junichiro Date Naoki Tsuruma Hirokazu Yamaga Kazuya Watanabe Hiroko Kijima Manami Nakashita Hiroki Hosokawa Masami Tsugita
- 出版者
- National Institute of Infectious Diseases, Japanese Journal of Infectious Diseases Editorial Committee
- 雑誌
- Japanese Journal of Infectious Diseases (ISSN:13446304)
- 巻号頁・発行日
- vol.74, no.3, pp.240-244, 2021-05-31 (Released:2021-05-24)
- 参考文献数
- 14
The prevalence of quinolone- and macrolide-resistant Group B Streptococcus (GBS) is increasing worldwide, but the relationship between the resistance of GBS to these antibiotics and patient outcome remains unclear. Therefore, we evaluated whether blood stream infection caused by quinolone- or macrolide-resistant GBS is associated with high mortality. Our findings in 77 patients with GBS bacteremia demonstrate that quinolone and macrolide resistance may not be risk factors for 30-day mortality.
- 著者
- Satoru Mitsuboshi Junichiro Date Naoki Tsuruma Hirokazu Yamaga Kazuya Watanabe Hiroko Kijima Manami Nakashita Hiroki Hosokawa Masami Tsugita
- 出版者
- National Institute of Infectious Diseases, Japanese Journal of Infectious Diseases Editorial Committee
- 雑誌
- Japanese Journal of Infectious Diseases (ISSN:13446304)
- 巻号頁・発行日
- pp.JJID.2020.589, (Released:2020-10-30)
- 参考文献数
- 14
The prevalence of quinolone- and macrolide-resistant Group B Streptococcus (GBS) is increasing worldwide, but the relationship between GBS resistance to these antibiotics and patient outcome remains unclear. Therefore, we evaluated whether blood stream infection caused by quinolone- or macrolide-resistant GBS is associated with high mortality. Our findings in 77 patients with GBS bacteremia demonstrate that quinolone and macrolide resistance may not be risk factors for 30-day mortality.
- 著者
- Satoru Mitsuboshi Naoki Tsuruma Kazuya Watanabe Shigehiro Takahashi Atsuko Ito Manami Nakashita Mitsuyuki Suzuki Kenichi Kobayashi Masami Tsugita
- 出版者
- National Institute of Infectious Diseases, Japanese Journal of Infectious Diseases Editorial Committee
- 雑誌
- Japanese Journal of Infectious Diseases (ISSN:13446304)
- 巻号頁・発行日
- vol.73, no.4, pp.JJID.2019.411, 2020-07-22 (Released:2020-07-22)
- 参考文献数
- 28
- 被引用文献数
- 4
A 5-year multicenter retrospective cohort study was conducted across six hospitals in Niigata, Japan. Patients (n = 179) with bacteremia due to extended-spectrum β-lactamase (ESBL)producing organisms were included in the study. The rates of appropriate carbapenem prescription were 61% (n = 41) in patients aged 65–84 years and 89% (n = 31) in those aged ≥ 85 years. Patients aged ≥ 85 years were significantly more likely to receive carbapenem than their younger counterparts. After propensity score matching, 65 patients were assigned to two groups based on age (65–84 years or ≥ 85 years). Multivariate regression analysis showed that other sites of infection had a positive association with 30-day mortality (odds ratio [OR], 27.50; 95% confidence interval [CI], 2.90–260.00) and biliary tract infection tended to have a positive association with 30-day mortality (OR, 8.90; 95% CI, 0.88– 89.90) compared with urinary tract infection. However, an age ≥ 85 years was not associated with 30-day mortality. Elderly patients aged ≥ 85 years were more likely to be treated with carbapenem; however, old age was not associated with 30-day mortality when bacteremia was caused by ESBLproducing organisms. These results may help clinicians justify withholding carbapenem in patients aged ≥ 85 years.