Background: 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.
Methods: 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.
Results: 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).
Conclusion: 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.
{"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}
Pub Date : 2026-02-11DOI: 10.1186/s40780-026-00552-8
Yuichi Muraki, Norio Ohmagari
{"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":"","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.2,"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}
Pub Date : 2026-02-09DOI: 10.1186/s40780-026-00551-9
Takumi Umemura
{"title":"Practical and clinical significance of the pharmacist-led antimicrobial stewardship.","authors":"Takumi Umemura","doi":"10.1186/s40780-026-00551-9","DOIUrl":"10.1186/s40780-026-00551-9","url":null,"abstract":"","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149488","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":"Biphasic dysglycemia induced by pentamidine and detected by intermittently scanned continuous glucose monitoring: a case report of a possible drug-drug interaction with clopidogrel and literature review.","authors":"Yuki Nakano, Noriko Kuhara, Rintaro Sogawa, Hisanari Yasukochi, Yusuke Okayama, Misato Motoya, Hidehiro Ishii, Hirotsugu Hasuwa, Chisato Shimanoe","doi":"10.1186/s40780-026-00549-3","DOIUrl":"10.1186/s40780-026-00549-3","url":null,"abstract":"","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12977656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137475","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}
Pub Date : 2026-02-07DOI: 10.1186/s40780-026-00543-9
Rei Tanaka, Tomoe Ichikawa, Junya Sato
{"title":"Storage stability of hospital-prepared mianserin suppositories: evaluation of residual active ingredient content and bacteriological contamination under different storage conditions.","authors":"Rei Tanaka, Tomoe Ichikawa, Junya Sato","doi":"10.1186/s40780-026-00543-9","DOIUrl":"10.1186/s40780-026-00543-9","url":null,"abstract":"","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12977472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137510","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":"Predictors of target initial teicoplanin trough concentration attainment in patients with hematological malignancies: a retrospective cohort study.","authors":"Kazuki Deguchi, Norihiro Sakurai, Toya Matsui, Mayuko Itoya, Makoto Miyoshi, Hiroshi Kawaguchi, Yasutaka Nakamura","doi":"10.1186/s40780-026-00550-w","DOIUrl":"10.1186/s40780-026-00550-w","url":null,"abstract":"","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125398","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":"Day 8 monocyte and lymphocyte counts as a novel and early predictor for discontinuation in gynecologic cancer patients receiving paclitaxel and carboplatin therapy: a retrospective observational study.","authors":"Hiroaki Watanabe, Keita Hirai, Hirofumi Komachiya, Takafumi Naito","doi":"10.1186/s40780-026-00547-5","DOIUrl":"10.1186/s40780-026-00547-5","url":null,"abstract":"","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12964638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119251","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}
Background: Kounis syndrome (KS) is an acute coronary syndrome (ACS) triggered by allergic reactions and is frequently associated with antibiotic exposure. However, patient characteristics of antibiotic-associated KS cases are not well described. Some cases with KS-consistent symptoms may instead be reported as antibiotic-associated allergic coronary events (non-KS) without proper diagnosis. Characterizing these non-KS events may improve the accurate diagnosis of KS. This study explores the clinical features of antibiotic-associated KS and non-KS allergic coronary events in the FDA Adverse Event Reporting System (FAERS) and generates hypotheses regarding potential underdiagnosis and improved recognition of KS.
Methods: FAERS reports (September 2012-December 2024) were screened for allergic symptoms (SMQ: Anaphylactic reaction; Hypersensitivity) and ACS (SMQ: Acute myocardial infarction) with antibiotics listed as suspected drugs. After exclusions, 459 cases (KS: 205; non-KS: 254) were included. Extracted variables included demographics, comorbidities, drug use (ATC classification), and outcomes. Logistic regression identified factors independently associated with non-KS classification.
Results: Non-KS group exhibited higher rates of cardiac comorbidities, diabetes, and mortality (all p < 0.05). Among suspected antibiotics, penicillins were the only class more frequently reported in KS cases (42% vs. 30%, p = 0.010). In the multivariable analysis, factors independently associated with non-KS classification included female sex (odds ratio [OR] = 1.804), fatal outcomes (OR = 4.320), and use of quinolones (OR = 11.108), aminoglycosides (OR = 3.480), renin-angiotensin agents (OR = 2.608), analgesics (OR = 2.055), and polypharmacy (OR = 3.314) (area under the curve = 0.815).
Conclusions: These exploratory findings indicate that non-KS allergic coronary events, characterized by higher comorbidities, mortality, and proportion of cases reporting the use of quinolones or aminoglycosides, may suggest a potential relationship between non-KS coronary events and KS underdiagnosis, warranting further prospective investigation.
{"title":"Comparative clinical features of antibiotic-associated Kounis syndrome and non-Kounis allergic coronary events: a disproportionality analysis using U.S. Food and Drug Administration Adverse Event Reporting System.","authors":"Ichiro Nakakura, Yutaro Mukai, Atsuki Hosoda, Naohiro Ohara, Kaori Yamanishi, Takaya Uno, Satoshi Yokoyama, Kouichi Hosomi, Yoshiko Une","doi":"10.1186/s40780-026-00545-7","DOIUrl":"10.1186/s40780-026-00545-7","url":null,"abstract":"<p><strong>Background: </strong>Kounis syndrome (KS) is an acute coronary syndrome (ACS) triggered by allergic reactions and is frequently associated with antibiotic exposure. However, patient characteristics of antibiotic-associated KS cases are not well described. Some cases with KS-consistent symptoms may instead be reported as antibiotic-associated allergic coronary events (non-KS) without proper diagnosis. Characterizing these non-KS events may improve the accurate diagnosis of KS. This study explores the clinical features of antibiotic-associated KS and non-KS allergic coronary events in the FDA Adverse Event Reporting System (FAERS) and generates hypotheses regarding potential underdiagnosis and improved recognition of KS.</p><p><strong>Methods: </strong>FAERS reports (September 2012-December 2024) were screened for allergic symptoms (SMQ: Anaphylactic reaction; Hypersensitivity) and ACS (SMQ: Acute myocardial infarction) with antibiotics listed as suspected drugs. After exclusions, 459 cases (KS: 205; non-KS: 254) were included. Extracted variables included demographics, comorbidities, drug use (ATC classification), and outcomes. Logistic regression identified factors independently associated with non-KS classification.</p><p><strong>Results: </strong>Non-KS group exhibited higher rates of cardiac comorbidities, diabetes, and mortality (all p < 0.05). Among suspected antibiotics, penicillins were the only class more frequently reported in KS cases (42% vs. 30%, p = 0.010). In the multivariable analysis, factors independently associated with non-KS classification included female sex (odds ratio [OR] = 1.804), fatal outcomes (OR = 4.320), and use of quinolones (OR = 11.108), aminoglycosides (OR = 3.480), renin-angiotensin agents (OR = 2.608), analgesics (OR = 2.055), and polypharmacy (OR = 3.314) (area under the curve = 0.815).</p><p><strong>Conclusions: </strong>These exploratory findings indicate that non-KS allergic coronary events, characterized by higher comorbidities, mortality, and proportion of cases reporting the use of quinolones or aminoglycosides, may suggest a potential relationship between non-KS coronary events and KS underdiagnosis, warranting further prospective investigation.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12958633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113637","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":"Association of family pharmacist continuity with patient-reported satisfaction in patients with metastatic cancer: a nationwide cross-sectional study.","authors":"Atsunobu Sagara, Tomofumi Watanabe, Tomoya Abe, Takatsune Shimizu, Shunsuke Shirozu, Hiroyuki Terakado","doi":"10.1186/s40780-026-00548-4","DOIUrl":"10.1186/s40780-026-00548-4","url":null,"abstract":"","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12958496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113616","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":"Association between the incidence of infusion-related reactions by obinutuzumab and the dose of corticosteroid as premedication: a multicenter retrospective cohort study.","authors":"Tatsuya Ohtsubo, Kazuhiro Yamamoto, Saori Matumoto, Kaori Ito, Yuzuka Sasa, Kosuke Tomishima, Satoshi Dote, Katuya Makihara, Yoshinori Wakasugi, Tsutomu Mitsuie, Kouhei Yamagiwa, Kazuo Sato, Hiroki Hasegawa, Nobuhiko Uoshima, Yumi Kitahiro, Kanji Tomogane","doi":"10.1186/s40780-026-00546-6","DOIUrl":"10.1186/s40780-026-00546-6","url":null,"abstract":"","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12958665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113562","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}
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