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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 4 of 4 Research Studies DisplayedTan MS, Gomez-Lumbreras A, Villa-Zapata L
Colchicine and macrolides: a cohort study of the risk of adverse outcomes associated with concomitant exposure.
The authors conducted a cohort study using electronic health records comparing encounters with colchicine plus a macrolide and colchicine with an antibiotic non-macrolide, then assessed the relationship between the two groups. They found that heart failure was more frequent in the colchicine plus a macrolide cohort and that there was also a higher mortality rate. As there is a significant increase in the risk of hepatic failure and mortality when colchicine is concomitantly administered with a macrolide, they concluded that colchicine should not be used concomitantly with these antibiotics or should be temporarily discontinued to avoid toxic levels of colchicine.
AHRQ-funded; HS025984.
Citation: Tan MS, Gomez-Lumbreras A, Villa-Zapata L .
Colchicine and macrolides: a cohort study of the risk of adverse outcomes associated with concomitant exposure.
Rheumatol Int 2022 Dec;42(12):2253-59. doi: 10.1007/s00296-022-05201-5..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Risk, Antibiotics, Medication: Safety, Patient Safety
Koo G, Yu R, Phillips E
Retrospective stratification of cephalosporin allergy label risk using validated penicillin allergy frameworks.
The purpose of this study was to validate whether a history-based risk criteria used for penicillin allergy labels (PALs) is applicable to cephalosporin allergy labels (CALs), or whether there are additional features that require evaluation. From 2014 to 2019, the researchers evaluated a total of 322 patients with a total of 384 CALs in their outpatient drug allergy clinic for a completion of skin testing or a direct oral challenge. A total of 77.1% of patients had a negative testing result and were challenged. A total of 99.1% oral challenges were tolerated, leading to label removal, with 2 failures. 4.9% of patients had negative skin testing results and were delabeled afterward due to reported tolerance of a relevant cephalosporin since their index reaction. 5.6% of patients with negative skin testing result did not undergo oral challenge initially, but subsequently tolerated a cephalosporin treatment, which would trigger delabeling. Therefore, 94.8% of patients included for analysis had a complete cephalosporin allergy evaluation up to the level of either known tolerance or positive testing. Only 5.2% of included patients had complete, negative skin testing result and unknown tolerance of a challenge or treatment. The researchers concluded that history-based risk stratification of CALs appears to be acceptable using the existing validated criteria for penicillin allergy, with the additional note that a reported reaction to an IV cephalosporin may be inherently more likely to test positive, and should be evaluated more carefully.
AHRQ-funded; HS026395.
Citation: Koo G, Yu R, Phillips E .
Retrospective stratification of cephalosporin allergy label risk using validated penicillin allergy frameworks.
J Allergy Clin Immunol Pract 2022 Sep;10(9):2472-75.e1. doi: 10.1016/j.jaip.2022.05.032..
Keywords: Antibiotics, Medication, Adverse Drug Events (ADE), Adverse Events
Butler AM, Durkin MJ, Keller MR
Association of adverse events with antibiotic treatment for urinary tract infection.
The purpose of this study was to compare the risk of relative harms associated with different antibiotics prescribed for the treatment of uncomplicated urinary tract infection (UTI). The researchers identified 1,169,033 healthy, nonpregnant women between the ages of 18 to 44 who had an uncomplicated UTI and who initiated an oral antibiotic regimen for the treatment of common uropathogens between July 2006 and September 2015. The study found that of the two first-line treatments, the drug trimethoprim-sulfamethoxazole (versus nitrofurantoin) was associated with a higher risk of adverse drug-related events including: hypersensitivity, acute renal failure, skin rash, urticaria, abdominal pain, and nausea/ vomiting, but a similar risk of adverse possible microbiome-related events. When researchers compared non-first line drugs with nitrofurantoin, the non-first line drugs were associated with a greater risk of adverse drug events and possible microbiome-related adverse events including non-Clostridium difficile diarrhea, C. difficile infection, vaginitis/vulvovaginal candidiasis, and pneumonia. The duration of the treatment influenced the risk of possible microbiome-related adverse events. The study concluded that the risk of adverse events differs widely by both antibiotic drug and duration of regimen.
AHRQ-funded; HS019455.
Citation: Butler AM, Durkin MJ, Keller MR .
Association of adverse events with antibiotic treatment for urinary tract infection.
Clin Infect Dis 2022 Apr 28;74(8):1408-18. doi: 10.1093/cid/ciab637..
Keywords: Antibiotics, Medication, Urinary Tract Infection (UTI), Adverse Drug Events (ADE), Adverse Events, Clostridium difficile Infections
Downes KJ, Rao MB, Kahill L
Daily serum creatinine monitoring promotes earlier detection of acute kidney injury in children and adolescents with cystic fibrosis.
The purpose of this study was to determine the impact of daily serum creatinine (SCr) measurement on amino-glycoside (AG)-associated acute kidney injury detection among patients with cystic fibrosis (CF). The study included 87 patients at a children’s hospital who received a total of 227 AG courses of 3 days or more.
AHRQ-funded; HS021114
Citation: Downes KJ, Rao MB, Kahill L .
Daily serum creatinine monitoring promotes earlier detection of acute kidney injury in children and adolescents with cystic fibrosis.
J Cyst Fibros. 2014 Jul;13(4):435-41. doi: 10.1016/j.jcf.2014.03.005..
Keywords: Adverse Drug Events (ADE), Antibiotics, Children/Adolescents, Medication, Respiratory Conditions