Guangdong Food and Drug Vocational College

Azithromycin and clarithromycin are commonly used to treat community-acquired pneumonia in adults aged ≥ 65, such as mycoplasma pneumonia. This study aims to evaluate adverse events (AEs) associated with azithromycin and clarithromycin in this age group by analyzing the FDA Adverse Event Reporting System (FAERS), providing insights for clinical use and management of AEs in this population.

We retrieved reports of AEs related to azithromycin and clarithromycin from the FAERS database. Disproportionality analysis was conducted using the Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-Gamma Poisson Shrinkage (MGPS) to identify AEs associated with azithromycin and clarithromycin in adults aged ≥ 65.

A total of 2,019 adverse event reports were retrieved for azithromycin, and 2,392 for clarithromycin. Off-label use (n = 349) and drug interactions (n = 487) were the most reported AEs in adults aged ≥ 65 for azithromycin and clarithromycin, respectively. Prolonged QT interval showed the strongest signal among AEs for azithromycin in this age group. Drug interaction-related medication errors had the strongest signal for clarithromycin. Seven signals not explicitly included in the azithromycin package insert were identified in adults aged ≥ 65. Fourteen signals not explicitly included in the clarithromycin package insert were identified.

Among adults aged ≥ 65, cardiac-related adverse events are more closely associated with azithromycin than with clarithromycin. Conversely, AEs related to drug interactions and psychiatric symptoms are more associated with clarithromycin. Additionally, clinicians should be vigilant regarding AEs not specified in the package inserts. The findings of this study may help optimize the selection of azithromycin and clarithromycin based on patient circumstances and assist clinicians in focusing on relevant AEs for early intervention.

Ureteral stents are prone to encrustation due to urinary crystallization and bacterial infection, leading to severe complications and restricting long-term use. In this study, a multifunctional hydrogel-based coating was developed, which integrates the crosslinking of polyacrylic acid coupled with zinc ions (PAA(Zn^2 +)) possessing antibacterial properties and polyvinylpyrrolidone (PVP) with hydrophilic lubrication properties on the PU stent (PPAZ/PU). This novel PPAZ/PU coating was devised to mitigate the challenges of bacterial infectious encrustation associated with stent placement in clinical settings. The coating was synthesized via complex decomposition and addition polymerization, forming a stable zinc-ion-rich crosslinked network. The intertwining of PVP and PAA(Zn²⁺) molecular chains, along with hydrogen bond formation, enhanced the hydrogel's cohesion and peel strength up to 1000 N/m. The hydrophilicity and lubricity of the PPAZ/PU-coated stent was markedly enhanced for clinical applications, with a reduction in contact angle and friction coefficient by a factor of 3.25 and 2.62, respectively. In vitro antibacterial assays and simulated infectious encrustation experiments revealed that the PPAZ/PU-coated stent had an antibacterial efficacy of over 99 % and halved the surface encrustation per unit area. This PPAZ/PU hydrogel-based coating strategy presents an efficacious solution to the anti-encrustation demands of ureteral stents, particularly in severe urinary tract infection scenarios.

Alpha-1-acid glycoprotein (AGP) is regarded as an inflammatory factor. Currently, the relationship between serum AGP levels and depression is controversial. We designed a cross-sectional study to explore the association between serum AGP levels and depression using data from the National Health and Nutrition Examination Survey (NHANES) from 2021 to 2023. The PHQ-9 questionnaire was used to investigate the depression symptoms of participants, and the PHQ-9 score ≥ 10 was regarded as depression. Weighted multivariate logistic regression models, weighted multiple linear models, restricted cubic splines models (RCS), subgroup analyses, and interaction tests were performed to explore the association of serum AGP levels with depression. ROC curves were used to plot the predictive effect of AGP on depression. The mediation analysis was conducted to assess the mediation effect of the TyG index. Our study revealed that serum AGP levels were positively and linearly associated with depression. In the fully adjusted model, the odds ratio of depression elevated by 1.04 times (OR = 2.04, 95 % CI: 1.17-3.57), and the PHQ-9 score increased by 1.47 (β = 1.47, 95 % CI: 0.37-2.56) for each ln-unit AGP level increase, respectively. A positive relationship was also observed in some subgroups. Furthermore, AGP presented a strong predictive effect on depression. In addition, the TyG index had a significant mediation effect on the relationship between serum AGP levels and depression. In general, our study provides some new insight into the role of AGP on depression and the mediation effect of the TyG index.