| アブストラクト | BACKGROUND: Ceftriaxone is believed to increase the risk of biliary infections due to pseudolithiasis caused by ceftriaxone-calcium precipitation, but this risk is not well understood. This study aimed to investigate whether ceftriaxone use is associated with an increased risk of biliary infections in pneumonia patients using a national inpatient database. METHODS: We analyzed the Diagnosis Procedure Combination database in Japan, identifying pneumonia patients between July 2010 and March 2022. Patients were grouped by treatment: ceftriaxone versus ampicillin-sulbactam or cefotaxime. Propensity score overlap-weighting was used to adjust for confounding factors. The primary outcome was a composite measure, including cholecystitis or cholangitis during hospitalization, and any percutaneous, endoscopic, or surgical interventions on the biliary tract. Secondary outcomes included individual components of the primary outcome. RESULTS: Of the 1 503 885 eligible patients, 558 725 received ceftriaxone, while 945 160 were treated with either ampicillin-sulbactam or cefotaxime. The mean dose of ceftriaxone was 1.7 g/day (standard deviation, 0.7 g/day), with a mean administration duration of 7.1 days (standard deviation, 3.8 days). Propensity score overlap-weighting analysis revealed that ceftriaxone treatment was associated with an increased incidence of the composite outcome (0.22% vs. 0.18%; risk difference, 0.05%; 95% confidence interval, 0.03%-0.07%; p < 0.001), as well as the secondary outcomes, including cholecystitis or cholangitis during hospitalization and percutaneous or endoscopic drainage of the gallbladder or biliary tract. CONCLUSION: Ceftriaxone use was associated with a slight increase in the risk of biliary infections. |
| ジャーナル名 | Pharmacoepidemiology and drug safety |
| Pubmed追加日 | 2025/5/22 |
| 投稿者 | Taniguchi, Jumpei; Aso, Shotaro; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo |
| 組織名 | Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Department of Health Services Research, Graduate School of Medicine, The;University of Tokyo, Tokyo, Japan.;Department of Health Policy and Informatics, Graduate School of Medical and;Dental Sciences, Institute of Science Tokyo, Tokyo, Japan. |
| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/40398875/ |