2.Clinical Efficacy and Safety of Arbekacin against Pneumonia in Febrile Neutropenia: A Retrospective Study in Patients with Hematologic Malignancies
Takashi OHASHI ; Yukiyoshi FUJITA ; Hiroyuki IRISAWA ; Hidemasa NAKAMINAMI ; Takahiro ARAI ; Masumi TAKAHASHI ; Emi MOMIYAMA ; Naoya MURATA ; Kayoko MURAYAMA ; Taeko SAITO
Infection and Chemotherapy 2022;54(1):80-90
Background:
Arbekacin (ABK) is an aminoglycoside that exhibits anti-methicillin-resistant Staphylococcus aureus (MRSA) and anti-Pseudomonas aeruginosa activities. Therefore, for patients with febrile neutropenia (FN) and concurrent pneumonia suspected to be caused by MRSA, ABK may be sufficiently effective even as a single agent.
Materials and Methods:
Patients with hematologic malignancies treated with ABK who met the following criteria were included: 1) fever during neutropenia or functional neutropenia, 2) FN complicated by pneumonia, and 3) possible infection by antimicrobial-resistant Grampositive cocci.
Results:
This study encompassed 22 episodes involving 19 patients, of which, 15 (68.2%) were successfully treated with ABK. Of the nine episodes showing inadequate response to other anti-MRSA drugs, eight were successfully treated with ABK. Grade 2 or worse adverse events included acute kidney injury (13.6%) and increased transaminase levels (9.1%).
Conclusion
The present study demonstrated that ABK is effective and safe in patients with FN and concurrent pneumonia caused by antimicrobial-resistant Gram-positive cocci. ABK may also be effective in patients who are unresponsive to other anti-MRSA drugs. Therefore, ABK may be beneficial in the treatment of pneumonia caused by antimicrobial-resistant Gram-positive cocci in patients with FN.
3.Phenotypic characteristics of pediatric inflammatory bowel disease in Japan: results from a multicenter registry
Katsuhiro ARAI ; Reiko KUNISAKI ; Fumihiko KAKUTA ; Shin-ichiro HAGIWARA ; Takatsugu MURAKOSHI ; Tadahiro YANAGI ; Toshiaki SHIMIZU ; Sawako KATO ; Takashi ISHIGE ; Tomoki AOMATSU ; Mikihiro INOUE ; Takeshi SAITO ; Itaru IWAMA ; Hisashi KAWASHIMA ; Hideki KUMAGAI ; Hitoshi TAJIRI ; Naomi IWATA ; Takahiro MOCHIZUKI ; Atsuko NOGUCHI ; Toshihiko KASHIWABARA ; Hirotaka SHIMIZU ; Yasuo SUZUKI ; Yuri HIRANO ; Takeo FUJIWARA
Intestinal Research 2020;18(4):412-420
Background/Aims:
There are few published registry studies from Asia on pediatric inflammatory bowel disease (IBD). Registry network data enable comparisons among ethnic groups. This study examined the characteristics of IBD in Japanese children and compared them with those in European children.
Methods:
This was a cross-sectional multicenter registry study of newly diagnosed Japanese pediatric IBD patients. The Paris classification was used to categorize IBD features, and results were compared with published EUROKIDS data.
Results:
A total of 265 pediatric IBD patients were initially registered, with 22 later excluded for having incomplete demographic data. For the analysis, 91 Crohn’s disease (CD), 146 ulcerative colitis (UC), and 6 IBD-unclassified cases were eligible. For age at diagnosis, 20.9% of CD, 21.9% of UC, and 83.3% of IBD-unclassified cases were diagnosed before age 10 years. For CD location, 18.7%, 13.2%, 64.8%, 47.3%, and 20.9% were classified as involving L1 (ileocecum), L2 (colon), L3 (ileocolon), L4a (esophagus/stomach/duodenum), and L4b (jejunum/proximal ileum), respectively. For UC extent, 76% were classified as E4 (pancolitis). For CD behavior, B1 (non-stricturingon-penetrating), B2 (stricturing), B3 (penetrating), and B2B3 were seen in 83.5%, 11.0%, 3.3%, and 2.2%, respectively. A comparison between Japanese and European children showed less L2 involvement (13.2% vs. 27.3%, P< 0.01) but more L4a (47.3% vs. 29.6%, P< 0.01) and L3 (64.8% vs. 52.7%, P< 0.05) involvement in Japanese CD children. Pediatric perianal CD was more prevalent in Japanese children (34.1% vs. 9.7%, P< 0.01).
Conclusions
Upper gastrointestinal and perianal CD lesions are more common in Japanese children than in European children.