Association between the hypokalaemia index based on area over the serum potassium concentration curve and occurrence of acute kidney injury in patients administered liposomal amphotericin B.

Background: Acute kidney injury (AKI) and hypokalaemia are common adverse events after treatment with liposomal amphotericin B (L-AMB).

Objectives: Because excess potassium (K) leakage occurs during renal tubular injury caused by L-AMB, measuring the decrease in rate of serum K concentration might be more useful to assess the renal impact of L-AMB than hypokalaemia identified from a one-point measurement. The effects of a decrease in K concentration and duration of hypokalaemia on AKI were investigated.

Cold sensitivity among female clinical nurses in Japan: A nationwide study.

Objectives: This study aimed to clarify the nature of cold sensitivity in female nurses working in hospitals in Japan.

Design: A cross-sectional post survey research design.

Settings: The questionnaire targeted nurses working in 14 hospitals across ten prefectures throughout Japan.

Correlation between Antimicrobial Resistance and the Hospital-Wide Diverse Use of Broad-Spectrum Antibiotics by the Antimicrobial Stewardship Program in Japan.

Increased antibiotic use and antibiotic homogeneity cause selective pressure. This study investigated the correlation between antibiotic diversity and antimicrobial resistance (AMR) in Gram-negative organisms. The days of therapy/100 patient-days (DOT) for four broad-spectrum antibiotic classes were evaluated for 2015-2022.

Correction of thrombocytopenia caused by linezolid with scheduled sequential tedizolid use in patients with vertebral osteomyelitis by antibiotic resistant Gram-positive organisms.

Introduction: Because of thrombocytopenia, linezolid treatment tends to be stopped before the completion of therapy for complicated infections that require prolonged antimicrobial administration. In contrast, tedizolid shows a favorable hematologic profile. The primary end-point of this study was to evaluate the efficacy of switching treatment to tedizolid in patients who developed thrombocytopenia during linezolid therapy.

Validation of Vancomycin Area under the Concentration-Time Curve Estimation by the Bayesian Approach Using One-Point Samples for Predicting Clinical Outcomes in Patients with Methicillin-Resistant Infections.

Area under the concentration-time curve (AUC)-guided vancomycin treatment is associated with decreased nephrotoxicity. It is preferable to obtain two samples to estimate the AUC. This study examined the usefulness of AUC estimation via trough concentration (C)-only sampling of 260 adults infected with methicillin-resistant (MRSA) who received vancomycin.

Enhanced loading dose of teicoplanin for three days is required to achieve a target trough concentration of 20 μg/mL in patients receiving continuous venovenous haemodiafiltration with a low flow rate.

Introduction: Because of its lower risk of renal toxicity than vancomycin, teicoplanin is the preferred treatment for methicillin-resistant Staphylococcus aureus infection in patients undergoing continuous venovenous haemodiafiltration (CVVHDF) in whom renal function is expected to recover. The dosing regimen for achieving a trough concentration (C) of ≥20 μg/mL remains unclear in patients on CVVHDF using the low flow rate adopted in Japan.

Methods: The study was conducted in patients undergoing CVVHDF with a flow rate of <20 mg/kg/h who were treated with teicoplanin.

Effect of nursing procedures on the hand skin temperature of female hospital nurses.

Aims: Nurses' hand temperature may affect patient comfort but has not been investigated. This study aimed to determine female hospital nurses' hand skin temperature and clarify the effects of measurement site, time, nursing procedures, and environment.

Design: An observational study.

Clinical efficacy and safety in patients treated with teicoplanin with a target trough concentration of 20 μg/mL using a regimen of 12 mg/kg for five doses within the initial 3 days.

Background: A trough concentration (C) ≥20 μg/mL of teicoplanin is recommended for the treatment of serious methicillin-resistant Staphylococcus aureus (MRSA) infections. However, sufficient clinical evidence to support the efficacy of this target C has not been obtained. Even though the recommended high C of teicoplanin was associated with better clinical outcome, reaching the target concentration is challenging.

Vancomycin loading dose is associated with increased early clinical response without attainment of initial target trough concentration at a steady state in patients with methicillin-resistant Staphylococcus aureus infections.

What Is Known And Objective: Vancomycin therapeutic guidelines suggest a loading dose of 25-30 mg/kg for seriously ill patients. However, high-quality data to guide the use of loading doses are lacking. We aimed to evaluate whether a loading dose (a) achieved a target trough concentration at steady state and (b) improved early clinical response.

Improvement in Hyperglycemia Prevents Surgical Site Infection Irrespective of Insulin Therapy in Non-diabetic Patients Undergoing Gastrointestinal Surgery.

Background: Intensive glycemic control is recommended to prevent surgical site infections (SSI). Our aim was to evaluate retrospectively the effect of improvement in hyperglycemia irrespective of insulin use on the incidence of SSI in non-diabetic patients.

Methods: The highest blood glucose (BG) concentration within 12 h (early peak BG) and the final BG from 12 to 24 h after surgery were evaluated in patients who underwent gastrointestinal surgery.

Clinical efficacy of teicoplanin in the treatment of bloodstream infection caused by methicillin-resistant coagulase-negative staphylococci.

Empirical combination therapy with β-lactams and glycopeptides is recommended for patients with presumed staphylococcal bloodstream infection (BSI). While coagulase-negative staphylococci (CNS) remain susceptible to vancomycin, such isolates have become less susceptible to teicoplanin. The aim of this retrospective study was to evaluate the clinical efficacy of teicoplanin in the treatment of BSI caused by methicillin-resistant CNS according to teicoplanin susceptibility.

Strict glycemic control to prevent surgical site infections in gastroenterological surgery.

Perioperative hyperglycemia is a risk factor for surgical site infections (SSI). Although the recommended target blood glucose level (BG) is 140-180 mg/dL for critically ill patients, recent studies conducted in patients undergoing surgery showed a significant benefit of intensive insulin therapy for the management of perioperative hyperglycemia. The aim of the present review is to evaluate the benefits of strict glycemic control for reducing SSI in gastroenterological surgery.

High-dose regimen to achieve novel target trough concentration in teicoplanin.

In the treatment of severe MRSA infections such as endocarditis, more than 20 mg/L of plasma trough concentration (C(min)) is recommended for teicoplanin; however, in the treatment of common MRSA infections, recommended C(min) remains more than 10 mg/L. In this study, we set C(min) as 15-30 mg/L to obtain a favorable clinical outcome in the treatment of common MRSA infections, and investigated the optimal loading regimen that achieved the target C(min) in patients with normal renal function. Seventy-eight patients received the high-dose regimen A (6 mg/kg every 12-h for initial two days) and 60 patients received the high-dose regimen B (the first five loading doses of 10-12 mg/kg at 12-h intervals for initial three days, followed by 6 mg/kg once daily).

Preferable timing of therapeutic drug monitoring in patients with impaired renal function treated with once-daily administration of vancomycin.

The aim of this study was to investigate the timing of therapeutic drug monitoring (TDM) in patients with impaired renal function treated with once-daily administration of vancomycin (VCM). Once-daily administration was selected for patients whose creatinine clearance (Ccr) was <80 ml/min. TDM was conducted on day 3 or on day 4.

Evaluation of teicoplanin dosing designs to achieve a new target trough concentration.

Minimum inhibitory concentration (MIC) creep in vancomycin has prompted guidelines that recommend a target trough concentration (C (min)) of 15-20 mg/L, and it is also considered necessary to set a C (min) of >15 mg/L for teicoplanin (TEIC), especially in patients with complicated methicillin-resistant Staphylococcus aureus (MRSA) infections. The aim of this study was to investigate the appropriate TEIC regimen for reaching the revised target C (min) (15-30 mg/L) in patients with normal renal function and those with renal dysfunction. We analyzed patients with MRSA infections who were treated with TEIC between July 2006 and December 2009.

Application of an electrolyzed strongly acidic aqueous solution before wound closure in colorectal surgery.

Background: Electrolyzed strongly acidic aqueous solution which is produced by electrolysis of a sodium chloride solution has been used in Japan for the irrigation of wounds or body cavities even in the absence of particular evidence.

Objective: The purpose of this study is to investigate the efficacy or harmful effects of the disinfectant when applied before wound closure in colorectal surgery.

Design: We performed a prospective, randomized study.

Risk factors associated with the development of thrombocytopenia in patients who received linezolid therapy.

The major adverse event associated with linezolid treatment is thrombocytopenia. This study investigated risk factors associated with the development of thrombocytopenia in patients who received linezolid therapy. This was a retrospective study of patients treated with linezolid 600 mg q12h, by the oral or parenteral route, between July 2007 and June 2009.

Clinical characteristics of vancomycin minimum inhibitory concentration of 2 μg/ml methicillin-resistant Staphylococcus aureus strains isolated from patients with bacteremia.

Recent studies demonstrated that mortality associated with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia was high when vancomycin was used to treat infections with strains that had a high vancomycin minimum inhibitory concentration (MIC). This study compared several characteristics of vancomycin MIC 2 μg/ml strains isolated from bacteremia with those isolated from infections other than bacteremia. A total of 128 episodes of MRSA bacteremia between 2005 and 2008 were followed-up, and compared with 631 MRSA infections other than bacteremia.

Risk factors associated with surgical site infection after ileal pouch-anal anastomosis in ulcerative colitis.

Purpose: Surgery for inflammatory bowel disease is known to be have an increased risk of morbidity. Few studies have investigated the risk factors for surgical site infection in patients undergoing surgery for inflammatory bowel disease restricted to ulcerative colitis, and no known precise evaluation of risk factors has been presented because of the many differences and confounding factors, such as disease specificities, surgical procedures, and patient characteristics. We evaluated the influences of patient conditions on the occurrence of surgical site infection after an ileal J-pouch-anal anastomosis for ulcerative colitis.

Surgical site infection following surgery for inflammatory bowel disease in patients with clean-contaminated wounds.

Background: It is generally believed that the accompanying conditions in patients with inflammatory bowel disease (IBD) are associated with a high incidence of surgical site infection (SSI), and sometimes these patients are classified as compromised hosts without definitive clinical evidence. The aim of this study was to clarify the impact of IBD on the occurrence and features of SSI in patients with clean-contaminated wounds.

Methods: We conducted prospective SSI surveillance of 580 patients with clean-contaminated wounds who underwent surgery between March 2006 and December 2007 using the National Nosocomial Infection Surveillance system.

Relationship between catheter care and catheter-associated urinary tract infection at Japanese general hospitals: a prospective observational study.

Background: The risk factors for catheter-associated urinary tract infections (CAUTIs) that are associated with catheter care have not been examined in detail by prospective studies or randomised clinical trials.

Objectives: To examine the patterns of catheter care and to identify the CAUTI risk factors associated with catheter care.

Design: Prospective observational study.

The effectiveness of a nurse-initiated intervention to reduce catheter-associated bloodstream infections in an urban acute hospital: an intervention study with before and after comparison.

Background: Catheter care is considered to be important for prevention of catheter-associated bloodstream infections (CABSIs) although epidemiological evidence is sparse.

Objectives: To identify problems associated with catheter care and evaluate the effectiveness of nurse-initiated interventions to reduce CABSIs.

Design: An intervention study with before and after comparison.