Risk Factors of Resistant Pathogens for β-Lactam Plus Macrolide, or Fluoroquinolone in Patients With CAP and HCAP: A Multicenter Prospective Observational Study Among Hospitalized Patients With CAP, HCAP, and HAP in Japan (CJLSG 0911)

CHEST Journal ◽  
2012 ◽  
Vol 142 (4) ◽  
pp. 150A ◽  
Author(s):  
Yuichiro Shindo ◽  
Ryota Ito ◽  
Daisuke Kobayashi ◽  
Masahiko Ando ◽  
Motoshi Ichikawa ◽  
...  
2020 ◽  
Author(s):  
Reiko Matsui ◽  
Kenichi Suzuki ◽  
Tomomi Takiguchi ◽  
Makoto Nishio ◽  
Takeshi Koike ◽  
...  

Abstract Background: Of patients receiving moderate emetic risk chemotherapy (MEC), 30%–90% experience chemotherapy-induced nausea and vomiting (CINV); however, the optimal antiemetic treatment remains controversial. Methods: In this multicenter, prospective, observational study of adults treated with MEC while receiving chemotherapy for various cancer types in Japan, the enrolled patients kept diaries documenting CINV. All participants received a 5-hydroxytryptamine-3 receptor antagonist and dexamethasone. Results: Of the 400 patients enrolled from May 2013 to January 2015, 386 were eligible for evaluation. The median age was 64 (range, 26–84). The overall complete response (CR; no emetic events and no antiemetic measures) rate was 64%. The proportion of patients showing CR was low in the carboplatin (CBDCA)- and oxaliplatin-based chemotherapy groups, especially among women. We showed that the CR rates in men were high in the CBDCA (AUC5) + etoposide (ETP) (80%), capecitabine plus oxaliplatin (CAPOX) (78%), and CBDCA+ paclitaxel (PTX) groups for lung cancer (73%). Total control (TC; no emetic events, no antiemetic measures, and no nausea) and complete control (CC; no emetic events, no antiemetic measures, and less than mild nausea) were achieved in 51% and 61% of patients, respectively. Logistic regression analysis revealed history of motion sickness, history of pregnancy-associated vomiting and CBDCA-based chemotherapy as risk factors for CR and history of motion sickness and history of pregnancy-associated vomiting as risk factors for TC. Additional, Ages ≥65 years is an independent predictive factor for achieving TC. Conclusion: Our data showed that two antiemetics were insufficient to control CINV in patients receiving CBDCA- or oxaliplatin-based chemotherapy. However, two antiemetics may be sufficiently effective for elderly male patients receiving CBDCA (AUC5)+ETP, CBDCA+PTX for lung cancer, or CAPOX. Additionally, we consider that three antiemetics are necessary for women with colorectal cancer receiving CAPOX. Risk factor analysis related to CR showed that CINV prophylaxis in patients treated with CBDCA-based chemotherapy was generally supportive of the guideline-recommended three antiemetics. However, the control of nausea in patients receiving non-CBDCA-based chemotherapy is a key point to note. The further individualization of antiemetic regimens for patients receiving MEC based on both types of chemotherapy regimens and sex is needed.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Reiko Matsui ◽  
Kenichi Suzuki ◽  
Tomomi Takiguchi ◽  
Makoto Nishio ◽  
Takeshi Koike ◽  
...  

Abstract Background Of patients receiving moderate emetic risk chemotherapy (MEC), 30–90% experience chemotherapy-induced nausea and vomiting (CINV); however, the optimal antiemetic treatment remains controversial. Methods In this multicenter, prospective, observational study of adults treated with MEC while receiving chemotherapy for various cancer types in Japan, the enrolled patients kept diaries documenting CINV. All participants received a 5-hydroxytryptamine-3 receptor antagonist and dexamethasone. Results Of the 400 patients enrolled from May 2013 to January 2015, 386 were eligible for evaluation. The median age was 64 (range, 26–84). The overall complete response (CR; no emetic events and no antiemetic measures) rate was 64%. The proportion of patients showing CR was low in the carboplatin (CBDCA)- and oxaliplatin-based chemotherapy groups, especially among women. We showed that the CR rates in men were high in the CBDCA (AUC5) + etoposide (ETP) (80%), capecitabine plus oxaliplatin (CAPOX) (78%), and CBDCA+ paclitaxel (PTX) groups for lung cancer (73%). Total control (TC; no emetic events, no antiemetic measures, and no nausea) and complete control (CC; no emetic events, no antiemetic measures, and less than mild nausea) were achieved in 51 and 61% of patients, respectively. Logistic regression analysis revealed history of motion sickness, history of pregnancy-associated vomiting and CBDCA-based chemotherapy as risk factors for CR and history of motion sickness and history of pregnancy-associated vomiting as risk factors for TC. Additional, Ages ≥65 years is an independent predictive factor for achieving TC. Conclusions Our data showed that two antiemetics were insufficient to control CINV in patients receiving CBDCA- or oxaliplatin-based chemotherapy. However, two antiemetics may be sufficiently effective for elderly male patients receiving CBDCA (AUC5) + ETP, CBDCA+PTX for lung cancer, or CAPOX. Additionally, we consider that three antiemetics are necessary for women with colorectal cancer receiving CAPOX. Risk factor analysis related to CR showed that CINV prophylaxis in patients treated with CBDCA-based chemotherapy was generally supportive of the guideline-recommended three antiemetics. However, the control of nausea in patients receiving non-CBDCA-based chemotherapy is a key point to note. The further individualization of antiemetic regimens for patients receiving MEC based on both types of chemotherapy regimens and sex is needed.


2021 ◽  
Vol 14 (1) ◽  
pp. 133-140
Author(s):  
Dong Eun Lee ◽  
◽  
Sungbae Moon ◽  
Jae Yun Ahn ◽  
Jung Ho Kim ◽  
...  

AIM: To identify the epidemiologic characteristics of sports- and recreation-related eye injuries in a large metropolitan city and investigate risk factors associated with visual impairment. METHODS: We performed a multicenter prospective observational study on patients using the regional eye injury registry data. This study included patients with sports- and recreation-related eye injury in four tertiary teaching hospitals in Daegu, Republic of Korea, from August 2016 to July 2018. The primary outcome was visual impairment at the first hospital visit. Distributions of sex, age, place, and causative materials were analyzed according to causative activities. To examine the association between causative activities and visual impairment, a Logistic regression analysis was used. RESULTS: Of the 349 sports- and recreation-related eye injuries, soccer was the most common causative activity, with 21.8% (n=76). Sports- and recreation-related eye injuries occurred mainly in teenagers, individuals in their 20s, and men. Badminton and soccer were significantly associated with visual impairment at the first hospital visit compared with combat sports [(adjusted odds ratio (AOR), 5.18; 95% confidence interval (CI), 1.67-16.09 for badminton and AOR, 3.87; 95%CI, 1.36-10.99 for soccer]. CONCLUSION: Intervention efforts such as deployment of protective eyewear in sports facilities and schools and promotion of wearing protective eyewear during these activities in teenagers and individuals in their 20s are mandatory.


2020 ◽  
Author(s):  
Reiko Matsui ◽  
Kenichi Suzuki ◽  
Tomomi Takiguchi ◽  
Makoto Nishio ◽  
Takeshi Koike ◽  
...  

Abstract Background: Of patients receiving moderate emetic risk chemotherapy (MEC), 30%–90% experience chemotherapy-induced nausea and vomiting (CINV); however, the optimal antiemetic treatment remains controversial.Methods: In this multicenter, prospective, observational study of adults treated with MEC while receiving chemotherapy for various cancer types in Japan, the enrolled patients kept diaries documenting CINV. All participants received a 5-hydroxytryptamine-3 receptor antagonist and dexamethasone.Results: Of the 400 patients enrolled from May 2013 to January 2015, 386 were eligible for evaluation. The median age was 64 (range, 26–84). The overall complete response (CR; no emetic events and no antiemetic measures) rate was 64%. The proportion of patients showing CR was low in the carboplatin (CBDCA)- and oxaliplatin-based chemotherapy groups, especially among women. We showed that the CR rates in men were high in the CBDCA (AUC5) + etoposide (ETP) (80%), capecitabine plus oxaliplatin (CAPOX) (78%), and CBDCA+ paclitaxel (PTX) groups for lung cancer (73%). Total control (TC; no emetic events, no antiemetic measures, and no nausea) and complete control (CC; no emetic events, no antiemetic measures, and less than mild nausea) were achieved in 51% and 61% of patients, respectively. Logistic regression analysis revealed history of motion sickness, history of pregnancy-associated vomiting and CBDCA-based chemotherapy as risk factors for CR and history of motion sickness and history of pregnancy-associated vomiting as risk factors for TC. Additional, Ages ≥65 years is an independent predictive factor for achieving TC.Conclusion: Our data showed that two antiemetics were insufficient to control CINV in patients receiving CBDCA- or oxaliplatin-based chemotherapy. However, two antiemetics may be sufficiently effective for elderly male patients receiving CBDCA (AUC5)+ETP, CBDCA+PTX for lung cancer, or CAPOX. Additionally, we consider that three antiemetics are necessary for women with colorectal cancer receiving CAPOX. Risk factor analysis related to CR showed that CINV prophylaxis in patients treated with CBDCA-based chemotherapy was generally supportive of the guideline-recommended three antiemetics. However, the control of nausea in patients receiving non-CBDCA-based chemotherapy is a key point to note. The further individualization of antiemetic regimens for patients receiving MEC based on both types of chemotherapy regimens and sex is needed.


2020 ◽  
Author(s):  
Reiko Matsui ◽  
Kenichi Suzuki ◽  
Tomomi Takiguchi ◽  
Makoto Nishio ◽  
Takeshi Koike ◽  
...  

Abstract Background Patients receiving moderate emetic risk chemotherapy (MEC) occurs chemotherapy-induced nausea and vomiting (CINV) in 30–90%, however the optimal antiemetic treatment remains controversial. Methods In this multicenter, prospective, observational study of adults treated with MEC for various cancer types in Japan, We enrolled patients kept diaries documenting CINV. All participants received a 5-HT3 receptor antagonist(5HT3RAs) and dexamethasone. We assessed various possible risk factors for complete response (CR; no emetic events and no antiemetic measures), total control (TC; no emetic events , no antiemetic measures and no nausea) and complete control (CC; no emetic events, no antiemetic measures and less than mild nausea) by univariate and multivariate analysis. Results Of the 400 patients enrolled from May 2013 to January 2015, 386 were eligible for evaluation. The overall CR rate was 64%, CBDCA-based chemotherapy and oxaliplatin-based chemotherapy were particularly low. However, we showed that the CR rates in men were high in CBDCA(AUC5)+ETP (80%), CapeOX (78%) and CBDCA+PTX for lung cancer(73% ). Emesis occurred significantly more women (30%) than men (16%) of patients overall. TC and CC were achieved by 51% and 61% of patients. Logistic regression analysis revealed that age <65 years and history of motion sickness or pregnancy-associated vomiting were risk factors for nausea and being women for vomiting. Conclusions Our data support triplet regimen including NK1 receptor antagonist with woman receiving CBDCA-based chemotherapy or oxaliplatin-based chemotherapy. However, it became clear that two antiemetics for men received CBDCA(AUC5)+ETP, CBDCA+PTX for lung cancer and CAPOX may be sufficiently effective. Further individualization of antiemetic regimens for patients receiving MEC on the basis of both type of chemotherapy regimen and sex is needed.


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