International Journal of Antimicrobial Agents最新文献

{"title":"Adverse effects of posaconazole on adrenal steroid biosynthesis: An integrative approach using FAERS-based pharmacovigilance and systematic review with meta-analysis of randomised controlled trials","authors":"Yuki Nakano ,&nbsp;Kazumasa Kotake ,&nbsp;Yuki Asai ,&nbsp;Masayuki Murata ,&nbsp;Masanobu Uchiyama ,&nbsp;Nobuyuki Shimono ,&nbsp;Hirotsugu Hasuwa","doi":"10.1016/j.ijantimicag.2025.107676","DOIUrl":"10.1016/j.ijantimicag.2025.107676","url":null,"abstract":"<div><h3>Objectives</h3><div>Posaconazole, a broad-spectrum azole antifungal agent, is used for prophylaxis and treatment of invasive fungal infections. However, it has been associated with pseudoaldosteronism—a syndrome involving hypertension, hypokalaemia, and QT prolongation—likely mediated by adrenal steroid biosynthesis inhibition. This study aimed to assess the association between posaconazole and pseudoaldosteronism using a triangulated approach integrating real-world pharmacovigilance data, clinical trial evidence, and a structured causality framework.</div></div><div><h3>Methods</h3><div>A disproportionality analysis of real-world pharmacovigilance data from the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) was performed to detect signals for pseudoaldosteronism, hypokalaemia, hypertension, and QT prolongation. Co-reported adverse events in pseudoaldosteronism cases were identified and counted. Clinical trial evidence was synthesised through a systematic review and meta-analysis (SR/MA) of randomised controlled trials comparing posaconazole with other antifungal agents. Causality was assessed based on the Bradford Hill criteria (BHC).</div></div><div><h3>Results</h3><div>In the FAERS analysis, posaconazole and itraconazole consistently showed signals for pseudoaldosteronism. Among reports of posaconazole, 29.8% (95% confidence interval [CI]: 22.1–38.4%) of pseudoaldosteronism cases co-occurred with hypokalaemia. The MA showed that posaconazole significantly increased the risk of hypokalaemia than did voriconazole (risk ratio: 10.41; 95% CI: 2.00–54.27; <em>I²</em> = 0%). Synthesising our findings from the FAERS analysis and SR/MA supported a causal relationship based on the BHC.</div></div><div><h3>Conclusions</h3><div>This study supports a causal association between posaconazole and pseudoaldosteronism by integrating clinical data from FAERS and SR/MA. Clinicians should closely monitor serum potassium during posaconazole therapy and consider pseudoaldosteronism in patients with hypokalaemia.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"67 1","pages":"Article 107676"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145633094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nanomedicine for phage therapy: Encapsulation strategies for enhanced antimicrobial efficacy","authors":"Alexis Dorta-Gorrín ,&nbsp;Verónica Salgueiriño ,&nbsp;Lorena García-Hevia","doi":"10.1016/j.ijantimicag.2025.107660","DOIUrl":"10.1016/j.ijantimicag.2025.107660","url":null,"abstract":"<div><div>Antibiotic resistance is a growing global health crisis, driving the need for alternative antimicrobial strategies. Phage therapy has re-emerged as a promising approach due to its specificity and ability to evolve against bacterial resistance mechanisms. However, therapeutic implementation is often challenged by factors such as phage stability, immune clearance, and site-specific delivery. Encapsulation technologies offer a potential solution, enhancing phage bioavailability, systemic circulation, and therapeutic action at the infection site.</div><div>This review explores the latest advancements in phage encapsulation within the context of nanomedicine-based delivery systems, including polymeric nanoparticles, liposomes, hydrogels, nanofibers, and inorganic nanoparticles. Each system is analyzed regarding its impact on phage stability, pharmacokinetics, and host-pathogen interactions, with a particular focus on applications in clinical and preclinical models of phage therapy. Liposomal and polymeric nanoparticle encapsulation enhance phage persistence in systemic circulation and protect them from degradation. Hydrogels and nanofibers improve localized phage delivery for wound healing applications, while inorganic nanoparticles and stimuli-responsive nanocarriers facilitate targeted delivery for intracellular and respiratory infections.</div><div>By leveraging nanotechnology-driven encapsulation, phage therapy can overcome key delivery challenges, expanding its potential for treating multidrug-resistant bacterial infections. This approach opens new possibilities for precision antimicrobial therapies, reinforcing phage therapy as a viable alternative to conventional antibiotics.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"67 1","pages":"Article 107660"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Model-informed precision pyrazinamide dosing: The establishment of a population pharmacokinetic model repository for clinical decision support","authors":"Huan Zhang ,&nbsp;Lu Han ,&nbsp;Xiao-Qin Liu ,&nbsp;Juan Wang ,&nbsp;Yi-Lin Yun ,&nbsp;Ming Zhou ,&nbsp;Zheng Jiao","doi":"10.1016/j.ijantimicag.2025.107658","DOIUrl":"10.1016/j.ijantimicag.2025.107658","url":null,"abstract":"<div><h3>Purpose</h3><div>Pyrazinamide (PZA) plays an important role in the treatment of tuberculosis (TB) and adequate PZA exposure is necessary to achieve optimal treatment outcomes. However, its pharmacokinetics exhibit marked interindividual variability. Such variability undermines the ‘one-dose-fits-all’ paradigm. Our work directly addresses this therapeutic dilemma by advancing model-informed precision dosing (MIPD) through systematic population pharmacokinetic (PPK) model evaluation.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive search of PubMed, Embase, and Web of Science to identify published PPK models and collected information on the study design, patient demographics, and final parameter estimates of these models. Based on the collected information, we used MIPD approach to establish a PZA PPK model repository and developed a web-based dashboard using R-shiny to visualize the concentration-time profile, investigate the impact of covariates on pharmacokinetic (PK), and estimate patient probability of target attainment (PTA) for a predefined dosing regimen.</div></div><div><h3>Results</h3><div>Sixteen studies conducted in adults and five studies conducted in paediatric patients were included in this model repository. Body size was identified as the most important covariate affecting the clearance of PZA. HIV/TB co-infection and pregnancy did not cause a significant change in PZA exposure; thus, no dosage adjustment was required. Moreover, to achieve the target exposure, the dosage per body weight was higher in paediatric and elderly patients with diabetes than in adults (40 mg/kg/24 h and 23 mg/kg/24 h for younger children and adults, respectively).</div></div><div><h3>Conclusions</h3><div>The developed model repository and dashboard have a broad range of potential applications in the MIPD of PZA.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"67 1","pages":"Article 107658"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global genomic epidemiology of carbapenemase-producing Klebsiella pneumoniae, 1996–2023","authors":"Yuxia Shi ,&nbsp;Dongxiao Ru ,&nbsp;Minge Wang ,&nbsp;Shengliang Cao ,&nbsp;Duanduan Chen ,&nbsp;Zhenshu Si ,&nbsp;Yuxi Zhang ,&nbsp;Yubao Li ,&nbsp;Jianbiao Lu","doi":"10.1016/j.ijantimicag.2025.107657","DOIUrl":"10.1016/j.ijantimicag.2025.107657","url":null,"abstract":"<div><h3>Objectives</h3><div>Carbapenem-resistant <em>Klebsiella pneumoniae</em> (CRKP) has emerged as a significant global public healthchallenge.</div></div><div><h3>Methods</h3><div>A total of 63,099 KP genomes was available in the NCBI Genome database, and assembly quality was further assessed using QUAST. Antibiotic resistance genes (ARGs), virulence factors (VFs), and plasmid replicons were identified with ABRicate. Multilocus sequence typing (MLST) was performed with MLST.</div></div><div><h3>Results</h3><div>This study conducted a systematic and comprehensive global genomic analysis of 35,471 CRKP isolates collected from 101 countries from 1996 to 2023. The results showed that China (25.11%), the United States (21.63%) and the United Kingdom 101 countries from 1996 to 2023. The results showed that China (25.11%), the United States (21.63%) and the United Kingdom peaked in 2018, followed by a declining trend. Our analysis revealed that carbapenemases in CRKP were predominantly KPC (53.93%), followed by NDM (25.58%) and OXA-48-like (21.86%). The isolates were classified into 1,046 known sequence types (ST), with the most common types being ST11 (23.90%), ST258 (12.85%), ST147 (7.64%), ST15 (5.21%), and ST307 (4.03%). Notably, all CRKP isolates carried multiple ARGs, with the United States having the highest number of unique ARGs. Principal coordinate analysis (PCoA) revealed that the composition of ARGs among CRKP isolates from China differs significantly from that of isolates in other countries. Furthermore, CRKP isolates from China carried the highest number of VFs, highlighting a distinct profile compared to other regions.</div></div><div><h3>Conclusions</h3><div>This study provides comprehensive data on CRKP, underscoring the necessity for continued global surveillance to monitor the dissemination of resistance and virulence.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"67 1","pages":"Article 107657"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P1-like phage-plasmids drive blaCTX-M-27 transmission through lysogenic conversion and transposition","authors":"Zengfeng Zhang,&nbsp;Chunlei Shi","doi":"10.1016/j.ijantimicag.2025.107686","DOIUrl":"10.1016/j.ijantimicag.2025.107686","url":null,"abstract":"<div><h3>Objective</h3><div>P1-like phage-plasmids (PPs) are hybrid mobile genetic elements that integrate features of both P1-like phages and plasmids. This study aimed to elucidate transfer mechanisms of antimicrobial resistance gene (ARG) <em>bla</em>_CTX-M-27 mediated by P1-like PPs in <em>S</em>. Indiana.</div></div><div><h3>Methods</h3><div>Antimicrobial susceptibility testing determined the antimicrobial resistance profiles of <em>S</em>. Indiana isolates. Phylogenomic analysis inferred the evolutionary structure of P1-like PPs and P1-carrying isolates, respectively. Conjugation, lytic infection, and lysogenic conversion assays assessed the transferability, lytic activity, and lysogeny potential of P1-like PPs. Transmission electron microscopy characterized P1-like bacteriophages morphology. Transposition assays quantified the transposition frequencies of Tn<em>1722</em> derivatives, and genome walking identified insertion sites and nucleotide composition biases.</div></div><div><h3>Results</h3><div>Among 147 <em>S.</em> Indiana isolates, 9 (6.1%) carried P1 elements, including 6 with <em>bla</em>_CTX-M-27. Phylogenetic analysis indicated the secondary acquisition of <em>bla</em>_CTX-M-27 and host-specific association with P1-like PPs in <em>S.</em> Indiana. Comparative genomic showed that the P1-like PP p14076B lacked key variable phage regions but harbored a Tn<em>1722</em> derivative carrying <em>bla</em>_CTX-M-27. Despite lacking plasmid-like conjugative capability, p14076B retained the ability to infect through lysogenic conversion. Transposition assays confirmed that the Tn<em>1722</em> derivative mediated the transfer of <em>bla</em>_CTX-M-27, with AT/GC skew shifts at insertion sites, and the <em>tnpA</em> gene significantly influenced transposition frequency.</div></div><div><h3>Conclusions</h3><div>These findings highlight that the Tn<em>1722</em> derivative mediates intra-host transfer of <em>bla</em>_CTX-M-27 through transposition, while lysogenic conversion of P1-like PPs facilitates inter-species dissemination. These insights provide critical understanding of the role of P1-like PPs in the spread of ARGs.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"67 1","pages":"Article 107686"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145633132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Streptomyces taklimakanensis sp. nov. TRM43335 produces 3-indole carbaldehyde a promising inhibitor of carbapenem-resistant Acinetobacter baumannii: In vitro and in vivo evaluation","authors":"Yanchun Qin ,&nbsp;Wen ting Zhou ,&nbsp;Ling Wang ,&nbsp;Shengqiang Yang ,&nbsp;Tao Zhu ,&nbsp;Gang Lu ,&nbsp;Kwanjit Duangsonk ,&nbsp;Hong Zeng","doi":"10.1016/j.ijantimicag.2025.107685","DOIUrl":"10.1016/j.ijantimicag.2025.107685","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to identify novel inhibitors against carbapenem-resistant <em>Acinetobacter baumannii</em> (CR-AB) derived from S<em>treptomyces taklimakanensis</em> sp. nov. TRM43335 and to evaluate their dual antibiofilm and anti-inflammatory mechanisms.</div></div><div><h3>Methods</h3><div>The TRM43335 extract yielded 3-indole carbaldehyde through bioactivity-guided isolation. Its antibiofilm activity was assessed using crystal violet, extracellular polymeric substances (EPS) quantification, motility, confocal laser scanning microscopy (CLSM), reverse transcription quantitative polymerase chain reaction (RT-qPCR) targeting <em>ompA</em> (outer-membrane protein A), <em>bfmR</em> (biofilm-associated regulator), and <em>bap</em> (biofilm-associated protein), and molecular docking. In vivo efficacy was evaluated in a murine pneumonia model by measuring bacterial burden, histology, and expression of inflammation-related proteins (Toll-like receptor 4 [TLR4], nuclear factor-κB [NF-κB], NOD-like receptor family pyrin domain-containing 3 [NLRP3], and mitogen-activated protein kinase [MAPK] pathway components) <em>via</em> western blotting.</div></div><div><h3>Results</h3><div>3-Indole carbaldehyde significantly reduced CR-AB biofilm, suppressed EPS/extracellular proteins, and impaired swarming motility, with marked downregulation of biofilm genes. In mice, 3-indole carbaldehyde treatment decreased lung bacterial load, improved histopathology and inhibited expression of TLR4, NF-κB, NLRP3, and MAPK pathway components (including p38, extracellular signal-regulated kinase 2 [ERK2], c-Jun N-terminal kinase [JNK], tumor necrosis factor receptor-associated factor 6 [TRAF6], and tumor necrosis factor alpha [TNF-α]), indicating suppression of inflammasome and MAPK signaling.</div></div><div><h3>Conclusion</h3><div>3-indole carbaldehyde simultaneously inhibits CR-AB biofilm formation and attenuates pulmonary inflammation. Thus, it represents a novel dual-action therapeutic strategy that addresses the key limitations of single-target antibiotics such as meropenem. Coupled with a favorable safety profile, it is a highly promising candidate for treating drug-resistant CR-AB infections.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"67 1","pages":"Article 107685"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145668246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of sulbactam-durlobactam disk diffusion and broth microdilution methods for Acinetobacter baumannii","authors":"Xiaolan Hong ,&nbsp;Xinying Wang ,&nbsp;Xin Xiang ,&nbsp;Siquan Shen ,&nbsp;Shaobo Zhou ,&nbsp;Xubo Dai ,&nbsp;Fupin Hu ,&nbsp;Yan Guo","doi":"10.1016/j.ijantimicag.2025.107659","DOIUrl":"10.1016/j.ijantimicag.2025.107659","url":null,"abstract":"<div><h3>Objective</h3><div>The broth microdilution method was used as a reference method to evaluate the accuracy of sulbactam-durlobactam disk diffusion method for <em>A. baumannii</em>.</div></div><div><h3>Methods</h3><div>In 2023, 504 nonduplicated <em>A. baumannii</em> isolated from 59 hospitals in China were tested by broth microdilution (M07) and disk diffusion method (M02) (10/10 µg) according to the CLSI M100 Ed34 standard. Categorical agreement (CA), minor error (mE), major error (ME), and very major error (VME) were calculated.</div></div><div><h3>Results</h3><div>By broth microdilution, the susceptibility, intermediate, and resistance proportions of <em>A. baumannii</em> against sulbactam-durlobactam were 98.4% (496/504),1% (5/504), and 0.6% (3/504), respectively. Compared to broth microdilution method, the CA and mE of all <em>A. baumannii</em> isolates detected by the disk diffusion method were 99.6% (502/504) and 0.4% (2/504), respectively, with no ME or VME. For carbapenem-susceptible <em>A. baumannii,</em> the CA of the disk diffusion method was 100% (184/184), with no mE and ME. For carbapenem-resistant <em>A. baumannii</em>, the CA and mE were 99.4% (318/320) and 0.6% (2/320), respectively, with no ME or VME. For difficult-to-treat resistant <em>A. baumannii</em>, the CA and mE were 99.2% (249/251) and 0.8% (2/251), respectively, with no ME or VME. For colistin-resistant <em>A. baumannii</em>, the disk diffusion method showed a CA of 100% (12/12) with no mE, ME, or VME.</div></div><div><h3>Conclusions</h3><div>The disk diffusion method (10/10 µg) accurately detects the susceptibility of <em>A. baumannii</em> to sulbactam-durlobactam. This method is characterised by its simplicity, economy, and ease of result interpretation, making it suitable for use in routine clinical microbiology laboratories.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"67 1","pages":"Article 107659"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consumption and expenditure on fidaxomicin and oral vancomycin for Clostridioides difficile infection: A 12-year longitudinal study of 43 countries and regions","authors":"Yin Zhang ,&nbsp;Xue Li ,&nbsp;Angel Y.S. Wong ,&nbsp;Vincent K.C. Yan ,&nbsp;Joseph E. Blais ,&nbsp;Jiaqi Wong ,&nbsp;Esther W. Chan ,&nbsp;Wai K. Leung","doi":"10.1016/j.ijantimicag.2025.107664","DOIUrl":"10.1016/j.ijantimicag.2025.107664","url":null,"abstract":"<div><h3>Background</h3><div>Current treatment guidelines recommend fidaxomicin and oral vancomycin as first-line treatments for <em>Clostridioides difficile</em> infection (CDI). Disparities in the prevalence of CDI and the availability of novel treatments necessitate understanding the contemporary trends in their consumption at the global level.</div></div><div><h3>Methods</h3><div>This longitudinal study used global pharmaceutical sales from IQVIA-MIDAS for fidaxomicin and oral vancomycin in 43 countries from 2012 to 2023. We measured defined daily doses per 100,000 inhabitants per year (DDD/100K) and manufacture-level prices, calculating changes using compound annual growth rates (CAGR). We conducted interrupted time-series analyses to assess the impact of guideline updates by Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America (IDSA/SHEA) on quarterly consumption.</div></div><div><h3>Results</h3><div>Overall fidaxomicin consumption increased from 21.68 DDD/100K in 2012 to 126.86 DDD/100K in 2023 (CAGR = 17.42%) and similar increases in expenditure (0.07–0.34 USD/capita; CAGR = 14.96%). Oral vancomycin consumption increased from 71.61 to 120.82 DDD/100K (CAGR = 4.87%), although with a decreasing trend in expenditure (0.20–0.03 USD/capita; CAGR = −15.16%). The earliest adoption of fidaxomicin in middle-income economies occurred five years later than in high-income economies. Despite higher CAGRs, consumption of fidaxomicin and oral vancomycin in middle-income economies was only 1.9% and 2.3%, respectively, of that in high-income economies in 2023. Following the IDSA/SHEA guideline updates, fidaxomicin consumption in Northern America increased immediately.</div></div><div><h3>Conclusion</h3><div>Consumption of fidaxomicin and oral vancomycin continues to increase globally; however, significant economic and geographical disparities in utilization highlight inequitable access to first-line CDI treatments.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"67 1","pages":"Article 107664"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of ceftazidime-avibactam with other appropriate antimicrobial therapy for the treatment of OXA-48- or KPC-producing Enterobacterales infections in Türkiye: A multi-centre retrospective matched-cohort study","authors":"Abdullah Tarık Aslan ,&nbsp;Elif Seren Tanriverdi ,&nbsp;Sibel Yıldız Kaya ,&nbsp;Gozde Dalgan ,&nbsp;Neşe Saltoğlu ,&nbsp;Ezgi Yılmaz ,&nbsp;Yeliz Çiçek ,&nbsp;Mesut Yılmaz ,&nbsp;Çiğdem Erol ,&nbsp;Özlem Kurt Azap ,&nbsp;Gülşen Hazırolan ,&nbsp;Osman Dağ ,&nbsp;Zeynep Türe Yüce ,&nbsp;Pinar Sagiroglu ,&nbsp;Damla Boztaş ,&nbsp;Muhammed Cihan Işık ,&nbsp;Bariş Otlu ,&nbsp;Patrick N.A. Harris ,&nbsp;David L. Paterson ,&nbsp;Murat Akova","doi":"10.1016/j.ijantimicag.2025.107650","DOIUrl":"10.1016/j.ijantimicag.2025.107650","url":null,"abstract":"<div><h3>Objective</h3><div>Due to underrepresentation of carbapenemase-producing <em>Enterobacterales</em> infections in randomized controlled trials with ceftazidime-avibactam (CZA) and high cost of CZA therapy, other appropriate antimicrobial therapies (OAAT) are still being used for OXA-48- or KPC-producing <em>Enterobacterales</em> infections in Türkiye.</div></div><div><h3>Methods</h3><div>We conducted a multicentre retrospective 1:1 matched cohort study of patients who received ≥48 h of CZA or OAAT for documented OXA-48- or KPC-producing <em>Enterobacterales</em> infections. Patients were matched based on (1) the number of days (± 1 d) from the infection onset to the initiation of therapy, (2) INCREMENT-CPE score (± 1), (3) source of infection, (4) year of infectious episode, and (5) type of causative microorganism.</div></div><div><h3>Results</h3><div>From 5 Turkish university hospitals, 180 patients were enrolled. Baseline characteristics were all similar between treatment groups. At the time of treatment initiation, 63.9% of patients were in the intensive care unit, 35.6% had septic shock and 41.1% required mechanical ventilation support. Thirty-day mortality occurred in 35.6% (32/90) of patients treated with CZA and in 56.7% (51/90) of those receiving OAAT regimens (<em>P</em> = 0.004). Twenty-one-day clinical response was seen in 50% (45/90) and 26.7% (24/90) of patients receiving CZA and OAAT, respectively (<em>P</em> = 0.002). In multivariable logistic regression analyses, CZA treatment was associated with less likelihood of mortality (aOR = 0.37; 95% CI: 0.19–0.71; <em>P</em> = 0.003) and higher likelihood of 21-d clinical response (aOR = 3.32; 95% CI: 1.68–6.53; <em>P</em> &lt; 0·001).</div></div><div><h3>Conclusions</h3><div>Treatment with CZA is associated with more favourable clinical outcomes in treatment of OXA-48- or KPC-producing <em>Enterobacterales</em> infections. A randomized controlled trial is needed to confirm these results.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"67 1","pages":"Article 107650"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145400641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of antimicrobial resistance measures and the emergence of COVID-19 on antimicrobial use throughout the Japanese population: A retrospective cohort study using a national claims database","authors":"Ryuji Koizumi ,&nbsp;Shinya Tsuzuki ,&nbsp;Yusuke Asai ,&nbsp;Kensuke Aoyagi ,&nbsp;Norio Ohmagari","doi":"10.1016/j.ijantimicag.2025.107667","DOIUrl":"10.1016/j.ijantimicag.2025.107667","url":null,"abstract":"<div><h3>Objective</h3><div>This study examined the impact of Japan’s National Action Plan on Antimicrobial Resistance (NAP) and the COVID-19 pandemic on national trends in antimicrobial consumption (AMC) for major infectious diseases.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analysed claims data for the Japanese population from 2013 to 2020. AMC was expressed as defined daily doses per 1000 inhabitants per day. The target diseases included upper respiratory infection (URI), otitis media, pneumonia, diarrhoea, urinary tract infection, skin and soft tissue infection, and sexually transmitted infection. Seasonally adjusted interrupted time-series analyses were conducted to assess the impact of NAP publication in 2016 and the COVID-19 outbreak in 2020 on the numbers of medically attended cases and antimicrobial prescription rates.</div></div><div><h3>Results</h3><div>Total AMC declined from 2016 to 2019, and decreased further in 2020. There was a significant decrease in medically attended cases in 2020 when compared to the counterfactual scenario in which COVID-19 did not occur. AMC was positively correlated with the number of medically attended cases. Total antimicrobial prescription rates decreased after NAP publication and the COVID-19 outbreak. Among the diseases, prescription rates for URI, otitis media, and pneumonia significantly decreased after both events. However, the prescription rate for diarrhoea decreased after NAP publication but increased after COVID-19. No significant trends were detected for other diseases.</div></div><div><h3>Conclusions</h3><div>Antimicrobial prescriptions for respiratory infections steadily decreased after NAP publication, which may indicate the effects of antimicrobial stewardship activities. Continued monitoring is needed to clarify the long-term effects of the COVID-19 pandemic on antimicrobial use.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"67 1","pages":"Article 107667"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}