Laboratory of Drug Informatics, Gifu Pharmaceutical University; Gifu, Japan.
Department of pharmacy, Kobe City Medical Center General Hospital; Kobe, Japan.
Int J Med Sci. 2020 Mar 26;17(7):921-930. doi: 10.7150/ijms.43789. eCollection 2020.
-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. : 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. : 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 × 1 drug was 21.81 (14.56-32.68). : 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.
与抗菌药物相关的结肠炎(CDAC)可能导致胃肠道疾病,严重程度从轻度腹泻到暴发性结肠炎甚至死亡不等。本研究旨在使用日本不良事件报告(JADER)数据库评估抗菌药物相关 CDAC 的特征。方法:我们选择了监管活动医学词典中规定的 CDAC 不良事件的病例报告。使用报告比值比(ROR)评估给予的抗菌药物数量与年龄之间的关系,并使用多元逻辑回归调整协变量。我们还使用威布尔形状参数评估了抗菌药物相关 CDAC 发病特征。结果:JADER 数据库包含 2004 年 4 月至 2018 年 6 月期间的 534688 份报告。共有 1222 例抗菌药物相关 CDAC 事件。排名前五的抗菌药物如下:第三代头孢菌素(解剖治疗化学分类代码:J01DD,313 例)、氟喹诺酮类(ATC 代码:J01MA,201 例)、大环内酯类(ATC 代码:J01FA,146 例)、碳青霉烯类(ATC 代码:J01DH,143 例)和扩展谱青霉素(ATC 代码:J01CA,103 例)。使用 1、2 和≥3 种抗菌药物的个体的调整后 ROR(95%置信区间)分别为 8.88(7.05-11.18)、9.77(6.89-13.86)和 18.39(11.85-28.54)。此外,47.2%的 CDAC 发生在抗菌药物治疗开始后 7 天内。年龄≥70 岁与 1 种药物的交互项的调整后 ROR 为 21.81(14.56-32.68)。结论:给予的抗菌药物数量和患者年龄与 CDAC 相关。这些数据可能对处方者特别有益,并有助于改善 CDAC 的管理。