| アブストラクト | Clostridium difficile-associated colitis (CDAC) may cause gastrointestinal illness, ranging in severity from mild diarrhea to fulminant colitis and even mortality. The purpose of this study was to evaluate anti-infective-related CDAC profiles using the Japanese Adverse Drug Event Report (JADER) database. Methods: We selected case reports of adverse events of CDAC as specified in the Medical Dictionary for Regulatory Activities. The association between the number of administered anti-infectives and aging was evaluated using reporting odds ratio (ROR) and adjusted for covariates using multiple-logistic regression. We also evaluated anti-infective-related CDAC-onset profiles using Weibull shape parameter. Results: The JADER database contained 534 688 reports from April 2004 to June 2018. There were 1222 anti-infective related CDAC events. The top five anti-infectives were as follows: third-generation cephalosporins (Anatomical Therapeutic Chemical (ATC) code: J01DD, 313 cases), fluoroquinolones (ATC code: J01MA, 201 cases), macrolides (ATC code: J01FA, 146 cases), carbapenems (ATC code: J01DH, 143 cases), and penicillins with extended spectrum (ATC code: J01CA, 103 cases). The adjusted RORs (95% confidence interval) in individuals using 1, 2, and >/= 3 anti-infectives were 8.88 (7.05-11.18), 9.77 (6.89-13.86), and 18.39 (11.85-28.54), respectively. Moreover, 47.2% of CDACs occurred within 7 days of anti-infective therapy initiation. The adjusted ROR of interaction terms of >/= 70 years x 1 drug was 21.81 (14.56-32.68). Conclusion: Our results suggest that the number of administered anti-infectives and patient age are associated with CDAC. These data may be particularly beneficial to prescribers and would contribute to improving the management of CDAC. |
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| ジャーナル名 | International journal of medical sciences |
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| Pubmed追加日 | 2020/4/21 |
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| 投稿者 | Nakao, Satoshi; Hasegawa, Shiori; Shimada, Kazuyo; Mukai, Ririka; Tanaka, Mizuki; Matsumoto, Kiyoka; Uranishi, Hiroaki; Masuta, Mayuko; Ikesue, Hiroaki; Hashida, Tohru; Iguchi, Kazuhiro; Nakamura, Mitsuhiro |
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| 組織名 | Laboratory of Drug Informatics, Gifu Pharmaceutical University; Gifu, Japan.;Department of pharmacy, Kobe City Medical Center General Hospital; Kobe, Japan.;Current address: Division of Pharmacy, Nara Medical University Hospital, 840,;Shijocho, Kashihara-shi, Nara, 634-8522, Japan.;Current address: Division of Pharmacy, Kyoto City Hospital, 1-2, Mibu;Higashitakadacho, Nakagyo-ku Kyoto-shi, Kyoto, 604-8845, Japan.;Laboratory of Community Pharmacy, Gifu Pharmaceutical University; Gifu, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/32308545/ |
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