{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:35:02Z","timestamp":1747186502439,"version":"3.40.5"},"reference-count":8,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T00:00:00Z","timestamp":1647820800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Toxic shock syndrome can be caused by methicillin\u2010resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (MRSA). During puerperium this condition is rare, and proper treatment during this period has not been clarified. Two patients developed toxic shock syndrome caused by MRSA soon after cesarean section. Despite the administration of antibiotics, both developed severe conditions and one of them required hysterectomy. The dosage was adjusted in the same way as nonpregnancy, but the actual drug concentration was significantly different from expectation. When there is severe infection during the early postpartum period, maintaining drug concentration at optimal levels may be difficult, and this could be life\u2010threatening. Better understanding of the pharmacokinetics and establishment of a method to determine the optimal drug dose during puerperium is required.<\/jats:p>","DOI":"10.1111\/jog.15221","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T01:33:28Z","timestamp":1647912808000},"page":"1484-1488","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Difficult maintenance of serum drug concentration in methicillin\u2010resistant <i>Staphylococcus aureus<\/i> toxic shock syndrome during early puerperium"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6459-5440","authenticated-orcid":false,"given":"Takashi","family":"Shibata","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Takatsuki General Hospital  Takatsuki Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7857-3392","authenticated-orcid":false,"given":"Satoshi","family":"Nakago","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Takatsuki General Hospital  Takatsuki Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Takatsuki General Hospital  Takatsuki Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hisato","family":"Tokuda","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Takatsuki General Hospital  Takatsuki Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sayoko","family":"Hosono","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Takatsuki General Hospital  Takatsuki Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumikazu","family":"Kotsuji","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Takatsuki General Hospital  Takatsuki Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,3,21]]},"reference":[{"volume-title":"Williams obstetrics","year":"2018","author":"Cunningham FG","key":"e_1_2_8_2_1"},{"issue":"2018","key":"e_1_2_8_3_1","first-page":"2670179","article-title":"Postpartum methicillin\u2010resistant Staphylococcus aureus toxic shock syndrome caused by a perineal infection","volume":"30","author":"Deguchi Y","year":"2018","journal-title":"Case Rep Obstet Gynecol"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181866468"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2009.02.040"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/149.3.471"},{"key":"e_1_2_8_7_1","unstructured":"Centers for Disease Control and Prevention.Toxic shock syndrome (other than Streptococcal) (TSS) 2011 case definition. 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