Journal of Infection and Chemotherapy最新文献

{"title":"Evaluation of cefazolin <3 g vs. 3 g treatment doses for cellulitis in patients who weigh ≥120 kg within a large, community health system via modified desirability of outcomes ranking (DOOR) methodology","authors":"Krista D. Gens ,&nbsp;Brandon R. Gagnon ,&nbsp;Kimberly C. Claeys ,&nbsp;Michael A. Wankum ,&nbsp;Elizabeth B. Hirsch","doi":"10.1016/j.jiac.2025.102833","DOIUrl":"10.1016/j.jiac.2025.102833","url":null,"abstract":"<div><h3>Background</h3><div>Cefazolin 3 g is recommended for patients ≥120 kg preoperatively; however, there is limited evidence to suggest 3 g for treatment dosing of cefazolin. This study aims to provide data on the efficacy and safety of high-dose cefazolin in obese patients with cellulitis using a modified Desirability of Outcomes Ranking (DOOR) methodology.</div></div><div><h3>Methods</h3><div>A multi-center, retrospective cohort study including adults weighing ≥120 kg who received ≥48 h of cefazolin for cellulitis in 2021 within a large, community health system was conducted. Patients were placed in a 3:1 ratio in &lt;3 g dosing (standard-dose; SD) and 3 g dosing (high-dose; HD) groups. Exclusion criteria included co-infections, bacteremia, diagnosis of bilateral lower extremity cellulitis, or receipt of &gt;48 h of concomitant antibiotics. The primary endpoint of efficacy and safety as determined by modified DOOR criteria.</div></div><div><h3>Results</h3><div>A total of 87 patients were included; 70 received SD and 17 received HD cefazolin. There were no differences in age, concomitant antibiotics, or severity of illness. Clinical success was higher in the HD vs SD group resulting in a 63.7% probability of a better outcome for a ≥120 kg patient receiving HD compared to SD (95% CI 50.4%, 75.2%, p = 0.0471).</div></div><div><h3>Conclusion</h3><div>Cefazolin 3 g was associated with a higher probability of a better outcome in patients ≥120 kg with cellulitis with no difference in adverse effects in this retrospective, cohort study utilizing modified DOOR criteria. Further study is necessary to confirm results.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 12","pages":"Article 102833"},"PeriodicalIF":1.5,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370257","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":"Strain-specific anti-RBD IgG antibody titers against the WT, XBB.1.5, JN.1, and KP.3 strains consistently correlate with neutralizing activity following SARS-CoV-2 XBB.1.5-adapted mRNA vaccination","authors":"Takeyuki Goto ,&nbsp;Yong Chong ,&nbsp;Tomonori Sato ,&nbsp;Naoki Tani ,&nbsp;Shouta Saiki ,&nbsp;Satoru Ishida ,&nbsp;Naoki Kawai ,&nbsp;Takuma Bando ,&nbsp;Hideyuki Ikematsu","doi":"10.1016/j.jiac.2025.102842","DOIUrl":"10.1016/j.jiac.2025.102842","url":null,"abstract":"<div><h3>Introduction</h3><div>Data on the correlation between SARS-CoV-2 neutralizing activity and strain-specific anti-RBD IgG antibody (anti-RBD) titers is limited, particularly in the context of XBB.1.5-adapted vaccination.</div></div><div><h3>Methods</h3><div>A direct comparison of neutralizing activity, measured as 50 % neutralization (NT₅₀), and anti-RBD titers, measured using an ELISA, was conducted using serum samples collected in Japan before and after XBB.1.5-adapted mRNA vaccination.</div></div><div><h3>Results</h3><div>A total of 108 serum samples from 54 patients were analyzed. A strong correlation between neutralizing activity and anti-RBD titers was observed for the wild-type (WT), XBB.1.5, JN.1, and KP.3 strains (r = 0.94, 0.87, 0.86, and 0.82, respectively). This correlation persisted when stratifying pre- and post-vaccination samples (r = 0.92, 0.83, 0.85, and 0.82, respectively, for pre-vaccination samples and r = 0.96, 0.85, 0.82, and 0.75, respectively, for post-vaccination samples). Both NT₅₀ and anti-RBD titers significantly increased against all four tested strains after vaccination (<em>p</em> &lt; 0.001), with the highest fold change observed for the XBB.1.5 variant. Additionally, variant specificity, defined as the ratio of variant to WT values, significantly increased for XBB.1.5, JN.1, and KP.3 after vaccination in NT₅₀ and was also observed in anti-RBD titers.</div></div><div><h3>Conclusions</h3><div>These findings, demonstrating a strong correlation with neutralizing activity not only against the WT strain but also against the XBB.1.5, JN.1, and KP.3 variants, suggest that strain-specific anti-RBD IgG antibody titers would be useful as an indicator of humoral immunity following XBB.1.5-adapted vaccination.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 12","pages":"Article 102842"},"PeriodicalIF":1.5,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365826","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":"The fourth nationwide surveillance of antimicrobial susceptibility against Neisseria gonorrhoeae from male urethritis in Japan, 2021","authors":"Mitsuru Yasuda ,&nbsp;Satoshi Takahashi ,&nbsp;Saori Oba ,&nbsp;Chikara Kumagai ,&nbsp;Masachika Saeki ,&nbsp;Mayumi Ono ,&nbsp;Yuuki Yakuwa ,&nbsp;Shinya Nirasawa ,&nbsp;Kanao Kobayashi ,&nbsp;Jun Miyazaki ,&nbsp;Koichiro Wada ,&nbsp;Masahiro Matsumoto ,&nbsp;Hiroshi Hayami ,&nbsp;Shingo Yamamoto ,&nbsp;Hiroshi Kiyota ,&nbsp;Junko Sato ,&nbsp;Naoki Hasegawa ,&nbsp;Tetsuya Matsumoto","doi":"10.1016/j.jiac.2025.102841","DOIUrl":"10.1016/j.jiac.2025.102841","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Neisseria gonorrhoeae</em>, an important pathogen of sexually transmitted infections, is resistant to all recommended antimicrobial agents, penicillins, tetracyclines, fluoroquinolones, oral third-generation cephalosporins and macrolides. Antimicrobial susceptibility surveillance of <em>N. gonorrhoeae</em> is needed to identify trends in its antimicrobial resistance. The fourth nationwide antimicrobial susceptibility surveillance of <em>N. gonorrhoeae</em> isolated from male urethritis was conducted by the Surveillance Committee of the Japanese Society of Infectious Diseases, the Japanese Society for Chemotherapy, and the Japanese Society of Clinical Microbiology.</div></div><div><h3>Methods</h3><div>Specimens of 1068 <em>N. gonorrhoeae</em> strains collected from male patients with or suspicious for urethritis at 50 facilities in 2021 were tested for antimicrobial susceptibility to 10 antimicrobial agents by CLSI methods.</div></div><div><h3>Results</h3><div>All strains were non-susceptible to penicillin G. The non-susceptible rate against cefixime was 7.4 %. At the Japanese dose, 39.6 % of strains were non-susceptible to cefixime. No strain was non-susceptible to ceftriaxone and spectinomycin. Susceptibility rates were ciprofloxacin, 24.7 %; tetracycline, 13.7 %; and azithromycin, 89.0 %. Only 0.47 % of isolated strains were resistant to all of cefixime, azithromycin, and ciprofloxacin. However, at the Japanese dose breakpoint, 31.8 % of strains were susceptible against azithromycin and 15.6 % of strains showed resistant to all of cefixime, azithromycin, and ciprofloxacin. Non-susceptibility rates against cefixime tended to be higher than the national average in Hokkaido, Kinki-Chugoku-Shikoku, and Tokai-Hokuriku regions, whereas those against ciprofloxacin tended to be higher in Kanto and Tokai-Hokuriku regions.</div></div><div><h3>Conclusion</h3><div>From these results, monotherapy with ceftriaxone or spectinomycin, which is currently recommended in Japanese guidelines for gonococcal infection, is considered appropriate. Continued gonococcal antimicrobial susceptibility surveillance is needed.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 12","pages":"Article 102841"},"PeriodicalIF":1.5,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370276","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":"Development and external validation of a population pharmacokinetic model and optimal Vancomycin dosing regimen for overweight and obese patients","authors":"Toshiaki Komatsu ,&nbsp;Atsushi Tomizawa ,&nbsp;Masaru Samura ,&nbsp;Ayako Suzuki ,&nbsp;Tomoyuki Ishigo ,&nbsp;Satoshi Fujii ,&nbsp;Yuta Ibe ,&nbsp;Hiroaki Yoshida ,&nbsp;Hiroaki Tanaka ,&nbsp;Hisato Fujihara ,&nbsp;Fumihiro Yamaguchi ,&nbsp;Fumiya Ebihara ,&nbsp;Takumi Maruyama ,&nbsp;Yusuke Yagi ,&nbsp;Yukihiro Hamada ,&nbsp;Fumio Nagumo ,&nbsp;Akitoshi Takuma ,&nbsp;Hiroaki Chiba ,&nbsp;Yoshifumi Nishi ,&nbsp;Yuki Igarashi ,&nbsp;Kazuaki Matsumoto","doi":"10.1016/j.jiac.2025.102838","DOIUrl":"10.1016/j.jiac.2025.102838","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to develop and evaluate a population pharmacokinetic model and optimal dosing regimen for vancomycin in overweight and obese adults.</div></div><div><h3>Methods</h3><div>A population pharmacokinetic model using a two-compartment system was constructed using a nonlinear mixed-effects approach, incorporating 527 data points from 184 participants. External validation of the model was carried out using an additional 55 data points from 21 participants; these were not used in the construction of the model. Monte Carlo simulations were used to determine the dosage that achieved the steady state area under the curve value falling between 400 μg h/mL and 600 μg h/mL.</div></div><div><h3>Results</h3><div>In the final model, vancomycin clearance was found to be a significant predictor of blood vancomycin levels, alongside creatinine clearance (CCr), blood urea nitrogen levels, and incidence of heart failure. CCr was calculated with adjusted body weight (AdjBW). AdjBW was selected as a predictor of the volume of distribution in the central and peripheral compartments. External validation showed that the highest proportion of cases had deviations of less than 15 % between measured and predicted values in the final model developed in this study. This indicates that our model outperforms previously developed models (five for obese patients and four for non-obese patients).</div></div><div><h3>Conclusions</h3><div>Our model shows that determining effective vancomycin doses for overweight and obese patients depend on estimated CCr rates, AdjBW, BUN levels, and incidence of heart failure.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 12","pages":"Article 102838"},"PeriodicalIF":1.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145368135","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":"The continued impact of COVID-19 during the Omicron era on immunocompromised individuals in Japan","authors":"Toshibumi Taniguchi ,&nbsp;Mitsuru Hoshino ,&nbsp;Ryotaro Ide ,&nbsp;Tomoyuki Homma ,&nbsp;Keiji Sugiyama ,&nbsp;Shinichi Kanazu ,&nbsp;Atsushi Maruyama ,&nbsp;Kazuhiro Tateda","doi":"10.1016/j.jiac.2025.102840","DOIUrl":"10.1016/j.jiac.2025.102840","url":null,"abstract":"<div><h3>Background</h3><div>Under Japan's Infectious Disease Act, coronavirus disease-2019 (COVID-19) was reclassified from a category II to a category V infectious disease, changing it from a notifiable disease to a sentinel disease within the surveillance system given the reduced risk of severe outcomes since the Omicron era. However, the COVID-19 disease burden in immunocompromised (IC) individuals during and after the Omicron era has not been sufficiently examined.</div></div><div><h3>Objectives</h3><div>The COVID-19 disease burden during and after the Omicron era in IC individuals in Japan was investigated.</div></div><div><h3>Methods</h3><div>This retrospective observational study used an insurance claims database. The baseline period was January 2018–December 2022; the study follow-up period was January 2023–December 2023, which coincided with the Omicron era. Adjusted incidence rate ratios (aIRRs) for COVID-19 related hospitalization, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, COVID-19 related intensive care unit (ICU) admission, and COVID-19 related death in IC individuals (vs non-IC individuals) were calculated using Poisson regression models.</div></div><div><h3>Results</h3><div>Data were analyzed for 3,433,430 individuals, including 179,268 IC individuals. The aIRR (95 % confidence interval [CI]) values for hospitalization, SARS-CoV-2 infection, ICU admission, and death were 2.60 (2.47–2.74), 1.12 (1.09–1.15), 2.94 (2.54–3.39), and 3.34 (3.07–3.65), respectively. Among IC individuals who had B cell-depleting therapy, solid organ transplantation, and hematologic malignancies, the aIRR (95 % CI) values for hospitalization were 5.10 (4.19–6.22), 4.00 (0.56–28.40), and 3.03 (2.65–3.45), respectively.</div></div><div><h3>Conclusion</h3><div>IC individuals had a high COVID-19 disease burden during the Omicron era. Appropriate preventive measures should be continued for this population.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 12","pages":"Article 102840"},"PeriodicalIF":1.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145368081","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":"Susceptibility of multidrug-resistant Aggregatibacter actinomycetemcomitans in vitro to amoxicillin-metronidazole and ciprofloxacin","authors":"Thomas E. Rams ,&nbsp;Arie J. van Winkelhoff","doi":"10.1016/j.jiac.2025.102836","DOIUrl":"10.1016/j.jiac.2025.102836","url":null,"abstract":"<div><div><em>Aggregatibacter actinomycetemcomitans</em> (<em>Aa</em>) is an important pathogen in human periodontitis, peri-implantitis and some non-oral infections. Simultaneous application of amoxicillin-metronidazole is synergistic against many <em>Aa</em> strains, including one resistant to both antibiotics individually. The present study evaluated the in vitro activity of amoxicillin-metronidazole in combination, as well as ciprofloxacin, on additional <em>Aa</em> clinical isolates resistant to both amoxicillin and metronidazole individually. A total of 26 <em>Aa</em> strains resistant to amoxicillin and metronidazole individually were recovered by selective culture from subgingival biofilm samples in United States patients with severe periodontitis. The clinical isolates were plated onto enriched Brucella blood agar supplemented with 8 mg/L of amoxicillin plus 16 mg/L of metronidazole to test for enhanced antimicrobial activity by the two antibiotics together, and onto <em>Haemophilus</em> test medium for ciprofloxacin (5 μg) disk diffusion testing. Among the 26 <em>Aa</em> study strains, 14 (53.9 %) were fully inhibited in vitro by the combination of amoxicillin-metronidazole, despite their resistance to both antibiotics individually. Partial inhibition by amoxicillin-metronidazole was found with 7 (26.9 %) <em>Aa</em> strains, whereas 5 (19.2 %) strains were unaffected by the drug combination. All 26 <em>Aa</em> study isolates were susceptible to ciprofloxacin. In conclusion, amoxicillin-metronidazole in combination exerted enhanced antimicrobial activity with total growth inhibition in vitro of approximately one-half of 26 <em>Aa</em> clinical isolates resistant to amoxicillin and metronidazole individually. All of the <em>Aa</em> study strains were susceptible in vitro to ciprofloxacin. These findings further support amoxicillin-metronidazole and ciprofloxacin drug therapies against susceptible <em>Aa</em> in oral and non-oral infections.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 11","pages":"Article 102836"},"PeriodicalIF":1.5,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345480","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":"High rate of HCV reinfection and the efficacy of standard regimens in men who have sex with men living with HIV","authors":"Eisuke Adachi,&nbsp;Yoshiaki Kanno,&nbsp;Michiko Koga,&nbsp;Hiroshi Yotsuyanagi","doi":"10.1016/j.jiac.2025.102837","DOIUrl":"10.1016/j.jiac.2025.102837","url":null,"abstract":"<div><div>In Japan, the prevalence of chronic hepatitis C virus (HCV) infection has declined due to the widespread use of direct-acting antivirals (DAAs). However, sexually transmitted HCV remains a concern among people with HIV (PWH), especially men who have sex with men (MSM). We examined PWH newly diagnosed with HCV infection between 2015 and 2024, focusing on reinfections. During this 10-year period, 26 cases were identified (incidence rate: 5.0 per 1000 person-years; 95 % CI: 3.2–7.3), including 7 reinfections (27 %). None experienced more than two episodes. Among the reinfection cases, two individuals without prior DAA treatment received sofosbuvir/ledipasvir for 12 weeks, while five with prior treatment received glecaprevir/pibrentasvir for 8 weeks. All achieved sustained virologic response, and no spontaneous clearance or relapse was observed. Unlike virologic failure, reinfection represents a new, treatable episode. Standard first-line regimens were effective without requiring longer or more costly therapies. These findings support the need to reframe HCV as a recurrent sexually transmitted infection. To ensure sustainable control in high-risk populations, healthcare systems must evolve to allow HCV treatment to be accessible, affordable, and repeatable, as is the case with the management of other common STIs.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 11","pages":"Article 102837"},"PeriodicalIF":1.5,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355070","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":"Oral gepotidacin for the treatment of uncomplicated urinary tract infection in Japanese female patients: a randomized, active reference, double-blind, double-dummy, Phase 3 trial (EAGLE-J)","authors":"Shingo Yamamoto ,&nbsp;Kenji Fujii ,&nbsp;Yoko Kayama ,&nbsp;Akinori Nimura ,&nbsp;Takao Maenaka ,&nbsp;Marcela Ramirez ,&nbsp;Rudrani Banerjee ,&nbsp;Nicole E. Scangarella-Oman ,&nbsp;Susan Mozzicato ,&nbsp;Shintaro Ura","doi":"10.1016/j.jiac.2025.102829","DOIUrl":"10.1016/j.jiac.2025.102829","url":null,"abstract":"<div><h3>Background</h3><div>Two global Phase 3 trials, EAGLE-2 and EAGLE-3, found gepotidacin non-inferior (and superior in EAGLE-3) to nitrofurantoin for the treatment of uUTI in female participants, with an acceptable safety profile; however, these studies did not include Japanese centers.</div></div><div><h3>Methods</h3><div>EAGLE-J (NCT05630833; jRCT2031220467) was a Phase 3, randomized, double-blind, active reference study evaluating the efficacy and safety of gepotidacin for the treatment of uUTI in Japan. Eligible participants were females aged ≥12 years with ≥2 uUTI symptoms and urinary nitrite or pyuria. Participants were randomly assigned (3:1) oral gepotidacin (1500 mg) or nitrofurantoin (100 mg) twice daily for 5 days. To bridge data, consistency of therapeutic response at test-of-cure (day 10–13) in the gepotidacin arm of EAGLE-J with EAGLE-2/EAGLE-3 was assessed in participants with qualifying nitrofurantoin-susceptible uropathogens (≥10⁵ colony-forming units/mL). Therapeutic success comprised clinical (symptom resolution) and microbiological success (eradication). Consistency was claimed if the therapeutic success rate in EAGLE-J was greater than the consistency threshold predicted from EAGLE-2/EAGLE-3.</div></div><div><h3>Findings</h3><div>Overall, the primary analysis included 108 participants (83 gepotidacin, 25 nitrofurantoin). At test-of-cure, gepotidacin therapeutic success was 83.1 % (69/83), exceeding the consistency threshold (48.2 %). Adverse events were mostly mild-to-moderate; common adverse events were diarrhea (gepotidacin: 60 %, 168/281; nitrofurantoin: 8 %, 7/93) and nausea (gepotidacin: 12 %, 35/281; nitrofurantoin: 2 %, 2/93). No fatalities occurred.</div></div><div><h3>Interpretation</h3><div>Gepotidacin therapeutic success at test-of-cure was consistent between EAGLE-J and EAGLE-2/-3. Gepotidacin has potential as a valuable oral treatment option for uUTI in Japan. No new safety signals were identified.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102829"},"PeriodicalIF":1.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318130","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":"Month 12 outcomes of switching to long-acting cabotegravir + rilpivirine with an oral lead-in versus continuing bictegravir/emtricitabine/tenofovir alafenamide in the Phase 3b randomized SOLAR study","authors":"Eisuke Adachi ,&nbsp;Yoshiyuki Yokomaku ,&nbsp;Dai Watanabe ,&nbsp;Hiroyuki Gatanaga ,&nbsp;Shinichi Oka ,&nbsp;Takuma Shirasaka ,&nbsp;Ronald D’Amico ,&nbsp;Kenneth Sutton ,&nbsp;Denise Sutherland-Phillips ,&nbsp;Jeremy Roberts ,&nbsp;John Thornhill ,&nbsp;Andrew Murungi ,&nbsp;Kimberley Brown","doi":"10.1016/j.jiac.2025.102834","DOIUrl":"10.1016/j.jiac.2025.102834","url":null,"abstract":"<div><div>Cabotegravir + rilpivirine (CAB + RPV) dosed every 2 months (Q2M) is the only complete long-acting (LA) regimen for maintaining HIV-1 virologic suppression. In some regions, prescribing information mandates a 4-week oral lead-in (OLI) before initiating CAB + RPV LA. To support clinical decision-making in these areas, we report a pre-specified analysis in adults living with HIV-1 who switched to CAB + RPV LA with an OLI versus continuing daily oral bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) for maintaining virologic suppression in the Phase 3b, randomized, open-label, SOLAR study. In SOLAR, participants with HIV-1 RNA &lt;50 copies/mL were randomized (2:1) to either intramuscular CAB + RPV LA Q2M, with a 1-month optional once-daily OLI of CAB + RPV, or to continue daily oral BIC/FTC/TAF. Month 12 endpoints included virologic response, safety, and patient-reported outcomes. Of 670 participants, 173 (39 %) switched to CAB + RPV LA with OLI, 274 (61 %) switched to CAB + RPV LA starting directly with injections, and 223 (33 %) continued BIC/FTC/TAF. At Month 12, the proportions of participants with HIV-1 RNA ≥50 copies/mL (CAB + RPV LA OLI, 1 % [n = 2/173]; BIC/FTC/TAF, &lt;1 % [n = 1/223]) and HIV-1 RNA &lt;50 copies/mL (CAB + RPV LA OLI, 87 % [n = 151/173]; BIC/FTC/TAF, 93 % [n = 207/223]) were similar between arms. Excluding injection site reactions, adverse events were comparable between arms; however, more participants in the CAB + RPV LA OLI arm had adverse events leading to withdrawal (5 % [n = 8/173] versus &lt;1 % [n = 2/227]). Overall, 87 % (n = 142/163) of participants who switched preferred CAB + RPV LA OLI to BIC/FTC/TAF. Switching to CAB + RPV LA OLI demonstrated comparable efficacy to continuing BIC/FTC/TAF, was well tolerated and preferred by most participants who switched.</div><div>ClinicalTrials.gov; NCT04542070 (<span><span>https://clinicaltrials.gov/study/NCT04542070</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 12","pages":"Article 102834"},"PeriodicalIF":1.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329524","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":"Successful combination therapy with voriconazole and micafungin for voriconazole-resistant Scedosporium dehoogii pulmonary infection: A case report with in vitro analysis","authors":"Kohei Yamazaki ,&nbsp;Makoto Osada ,&nbsp;Naoto Maruguchi ,&nbsp;Teppei Arai ,&nbsp;Shiho Furuya ,&nbsp;Masataka Kato ,&nbsp;Hisako Kunieda ,&nbsp;Yuiko Tsukada ,&nbsp;Akira Watanabe ,&nbsp;Ayumi Yoshifuji ,&nbsp;Takahide Kikuchi","doi":"10.1016/j.jiac.2025.102832","DOIUrl":"10.1016/j.jiac.2025.102832","url":null,"abstract":"<div><div><em>Scedosporium</em> infections are challenging to treat due to broad antifungal resistance. Voriconazole (VRCZ) is the recommended first-line therapy for scedosporiosis; however, resistance has been reported in several species.</div><div>We report the case of a 57-year-old female with Philadelphia chromosome-positive acute lymphoblastic leukemia who developed a pulmonary infection caused by <em>Scedosporium dehoogii</em> following cord blood transplantation. Despite VRCZ monotherapy, the lung mass enlarged. Antifungal susceptibility testing revealed a VRCZ minimum inhibitory concentration of 8 mg/L, indicating that the strain is resistant to VRCZ. Combination therapy with VRCZ and micafungin (MCFG) was initiated, leading to progressive radiological improvement over 8 weeks. <em>In vitro</em> checkerboard testing of the isolate revealed no synergistic effects. To explore reproducibility, we also tested four stored <em>S. dehoogii</em> strains; one demonstrated synergy, whereas the others showed no interaction. This case suggests that VRCZ–MCFG combination therapy may be clinically effective against VRCZ-resistant <em>S. dehoogii</em>, even when <em>in vitro</em> synergy is not observed.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 11","pages":"Article 102832"},"PeriodicalIF":1.5,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313063","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}