{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:46:40Z","timestamp":1759538800840,"version":"build-2065373602"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"The Research Foundation for Pharmaceutical Sciences"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Although the albumin\u2013bilirubin (ALBI) score and fibrosis-4 (FIB-4) index may help predict cefepime-induced liver enzyme abnormalities, the relationship between these measures and liver enzyme abnormalities has not been elucidated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>This study investigated the relevance and predictive accuracy of the ALBI score and FIB-4 index for cefepime-induced liver enzyme abnormalities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients and methods<\/jats:title>\n                  <jats:p>This single-centre retrospective case\u2013control study included 473 patients. The primary outcomes were cefepime-induced abnormal liver enzyme levels. Cox regression analysis was performed with male sex, cumulative dose (\u226536\u2005g), concomitant use of acetaminophen or voriconazole, alkaline phosphatase (\u2265238\u2005IU\/L), ALBI score (\u2265\u22121.45) and FIB-4 index (\u22654.69) as explanatory variables. The predictive accuracies of the ALBI score and FIB-4 index were evaluated based on the AUC using the receiver operating characteristic curve. We performed 1:1 propensity score matching between FIB-4 index\u200a\u22654.69 and FIB-4 index\u200a&amp;lt;\u200a4.69 groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The incidence of abnormal liver enzyme levels was 15.6% (74\/473). Cox regression analysis revealed that the ALBI score (adjusted hazard ratio, 2.10; 95% CI, 1.268\u22123.491; P\u200a=\u200a0.004) and FIB-4 index (adjusted hazard ratio, 2.33; 95% CI, 1.425\u22123.796; P\u200a=\u200a0.001) were independent risk factors for liver enzyme abnormalities. For all patients, the FIB-4 index (AUC: 0.629) exceeded the ALBI score (AUC: 0.530). Similar results were observed even after propensity score matching.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The progression of liver fibrosis before cefepime administration, as assessed using the FIB-4 index, could be more useful than the ALBI score in predicting the risk of developing abnormal liver enzyme levels.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkaf291","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T04:39:42Z","timestamp":1754282382000},"page":"2742-2751","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of the risk of developing cefepime-induced abnormal liver enzyme levels using the albumin\u2013bilirubin score and fibrosis-4 index: a single-centre retrospective case\u2013control study"],"prefix":"10.1093","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6922-0284","authenticated-orcid":false,"given":"Hiroki","family":"Katsu","sequence":"first","affiliation":[{"name":"Pharmacy, NHO Nagoya Medical Center , 4-1-1, Sannomaru, Naka-ku, Nagoya ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1933-8592","authenticated-orcid":false,"given":"Yuki","family":"Asai","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Faculty of Medicine, Mie University Hospital, Mie University , 2-174 Edobashi, Tsu, Mie ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6445-4410","authenticated-orcid":false,"given":"Takuya","family":"Iwamoto","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Faculty of Medicine, Mie University Hospital, Mie University , 2-174 Edobashi, Tsu, Mie ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryuji","family":"Hirano","sequence":"additional","affiliation":[{"name":"Pharmacy, NHO Nagoya Medical Center , 4-1-1, Sannomaru, Naka-ku, Nagoya ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"key":"2025100314260018800_dkaf291-B1","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1111\/liv.13535","article-title":"Acute liver failure induced by idiosyncratic reaction to drugs: challenges in diagnosis and therapy","volume":"38","author":"Tujios","year":"2018","journal-title":"Liver Int"},{"key":"2025100314260018800_dkaf291-B2","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1111\/liv.13931","article-title":"The diagnosis and management of idiosyncratic drug-induced liver injury","volume":"39","author":"Hassan","year":"2019","journal-title":"Liver 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