{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T03:15:40Z","timestamp":1764731740863,"version":"3.43.0"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ceftriaxone is believed to increase the risk of biliary infections due to pseudolithiasis caused by ceftriaxone\u2010calcium precipitation, but this risk is not well understood. This study aimed to investigate whether ceftriaxone use is associated with an increased risk of biliary infections in pneumonia patients using a national inpatient database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed the Diagnosis Procedure Combination database in Japan, identifying pneumonia patients between July 2010 and March 2022. Patients were grouped by treatment: ceftriaxone versus ampicillin\u2010sulbactam or cefotaxime. Propensity score overlap\u2010weighting was used to adjust for confounding factors. The primary outcome was a composite measure, including cholecystitis or cholangitis during hospitalization, and any percutaneous, endoscopic, or surgical interventions on the biliary tract. Secondary outcomes included individual components of the primary outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 1\u2009503\u2009885 eligible patients, 558\u2009725 received ceftriaxone, while 945\u2009160 were treated with either ampicillin\u2010sulbactam or cefotaxime. The mean dose of ceftriaxone was 1.7\u2009g\/day (standard deviation, 0.7\u2009g\/day), with a mean administration duration of 7.1\u2009days (standard deviation, 3.8\u2009days). Propensity score overlap\u2010weighting analysis revealed that ceftriaxone treatment was associated with an increased incidence of the composite outcome (0.22% vs. 0.18%; risk difference, 0.05%; 95% confidence interval, 0.03%\u20130.07%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), as well as the secondary outcomes, including cholecystitis or cholangitis during hospitalization and percutaneous or endoscopic drainage of the gallbladder or biliary tract.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ceftriaxone use was associated with a slight increase in the risk of biliary infections.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.70162","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T20:10:06Z","timestamp":1747858206000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association Between Ceftriaxone Use and Biliary Infections in Patients With Pneumonia: A Nationwide Retrospective Cohort Study"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2480-9018","authenticated-orcid":false,"given":"Jumpei","family":"Taniguchi","sequence":"first","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7804-2433","authenticated-orcid":false,"given":"Shotaro","family":"Aso","sequence":"additional","affiliation":[{"name":"Department of Health Services Research, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Matsui","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyohide","family":"Fushimi","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences Institute of Science Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6017-469X","authenticated-orcid":false,"given":"Hideo","family":"Yasunaga","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,21]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-198427060-00001"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200262070-00005"},{"issue":"4","key":"e_1_2_12_4_1","first-page":"167","article-title":"High Biliary Elimination of Ceftriaxone in Man","volume":"26","author":"Brogard J. M.","year":"1988","journal-title":"International Journal of Clinical Pharmacology, Therapy, and Toxicology"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.34.6.1146"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.2147\/TCRM.S79419"},{"issue":"4","key":"e_1_2_12_7_1","first-page":"404","article-title":"Biliary Precipitation During Ceftriaxone Therapy: Frequency and Risk Factors","volume":"49","author":"Soysal A.","year":"2007","journal-title":"Turkish Journal of Pediatrics"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1097\u20100096(200005)28:4<166::aid\u2010jcu2>3.0.co;2\u2010g"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.2147\/DHPS.S183892"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.7611-21"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11604-019-00893-5"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/JMU.JMU_132_20"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40792-022-01450-5"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1155\/2009\/132452"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2019-317950"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.2005.25.10.1389"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.37737\/ace.1.3_76"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.37737\/ace.24015"},{"key":"e_1_2_12_19_1","first-page":"61","article-title":"Functional Evaluation: The Barthel Index","volume":"14","author":"Mahoney F. I.","year":"1965","journal-title":"Maryland State Medical Journal"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.2188\/jea.JE20220147"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102013\u2010002736"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l5657"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.7819"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3697"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.6607"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1159\/000529522"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2004.05.020"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/730250"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201908-1581ST"}],"container-title":["Pharmacoepidemiology and Drug Safety"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pds.70162","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T12:04:10Z","timestamp":1754913850000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pds.70162"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,21]]},"references-count":28,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1002\/pds.70162"],"URL":"https:\/\/doi.org\/10.1002\/pds.70162","archive":["Portico"],"relation":{},"ISSN":["1053-8569","1099-1557"],"issn-type":[{"type":"print","value":"1053-8569"},{"type":"electronic","value":"1099-1557"}],"subject":[],"published":{"date-parts":[[2025,5,21]]},"assertion":[{"value":"2025-02-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70162"}}