{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T16:34:26Z","timestamp":1793637266478,"version":"4.5.1"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T00:00:00Z","timestamp":1766793600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":32,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Pharm Health Care Sci"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cefmetazole (CMZ) is widely used in Japan to treat infections such as urinary tract infections (UTIs), intra-abdominal infections, and bloodstream infections. However, pharmacokinetic and pharmacodynamic (PK\/PD) data supporting the appropriate use of CMZ in Japanese patients with UTIs remain limited. Thus, as a preliminary study, we evaluated steady-state plasma concentrations of CMZ in Japanese patients with mild to moderate UTIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty-three patients with mild to moderate UTIs admitted to the Department of Urology at Gifu Prefectural General Medical Center from October 2022 to January 2023 were enrolled. Two patients were excluded due to inappropriate sampling timing and lack of steady-state samples, resulting in 21 patients included in the final analysis. Repeated doses of cefmetazole (CMZ, 1 g-per dose) were administered at various intervals (6, 8, 12, or 24\u00a0h) based on renal function. Steady-state plasma samples 2\u20133.25\u00a0h after infusion (near peak) as well as just before the next dose (near trough) were collected. Plasma concentrations of CMZ were measured using a validated high-performance liquid chromatography (HPLC) method. The relationship between plasma concentrations of CMZ and creatinine clearance (Ccr) was analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CMZ effectively treated ESBL-E-induced UTIs in all patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095). With CMZ dosing regimens based on renal function, the mean (\u00b1\u2009SD) steady-state plasma concentrations at near-peak and near-trough were 73.8\u2009\u00b1\u200927.1\u00a0\u00b5g\/mL and 14.0\u2009\u00b1\u200911.0\u00a0\u00b5g\/mL, respectively. Steady-state near-peak plasma concentrations of CMZ (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919) were found to be negatively correlated with Ccr (\n                      <jats:italic>R<\/jats:italic>\n                      \u2009=\u2009\u2212\u20090.70,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). However, there is no correlation between Ccr and near-trough plasma concentrations of CMZ (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911,\n                      <jats:italic>R<\/jats:italic>\n                      \u2009=\u2009\u2212\u20090.53).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Preliminary clinical data suggest the potential appropriateness of the CMZ dosing regimen in patients with mild to moderate UTIs based on renal function, although further detailed population PK\/PD analysis would be necessary.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40780-025-00535-1","type":"journal-article","created":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T04:34:34Z","timestamp":1766810074000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Preliminary clinical evaluation of cefmetazole dosing regimens in Japanese patients with urinary tract infections"],"prefix":"10.1186","volume":"12","author":[{"given":"Yuna","family":"Sadaka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kokoro","family":"Nakajima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Sasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mao","family":"Tsurugaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhisa","family":"Oida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Midori","family":"Soda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Hirashita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kotoe","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshito","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Yokoi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyoyuki","family":"Kitaichi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,27]]},"reference":[{"key":"535_CR1","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1128\/CMR.00023-13","volume":"26","author":"PL Woerther","year":"2013","unstructured":"Woerther PL, Burdet C, Chachaty E, Andremont A. Trends in human fecal carriage of extended-spectrum \u03b2-lactamases in the community: toward the globalization of CTX-M. Clin Microbiol Rev. 2013;26:744\u201358.","journal-title":"Clin Microbiol Rev"},{"key":"535_CR2","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1038\/nature.2017.21550","volume":"543","author":"C Willyard","year":"2017","unstructured":"Willyard C. The drug-resistant bacteria that pose the greatest health threats. Nature. 2017;543:15.","journal-title":"Nature"},{"key":"535_CR3","first-page":"1951","volume":"35","author":"F Doko","year":"1982","unstructured":"Doko F. Preliminary and clinical investigations of cefmetazole in the obstetric and gynecological field. Jpn J Antibiot. 1982;35:1951\u20136.","journal-title":"Jpn J Antibiot"},{"key":"535_CR4","first-page":"1211","volume":"34","author":"Y Kasai","year":"1981","unstructured":"Kasai Y, Nakanishi Y, Kawamoto K, Miyagawa K, Hakozaki H, Abe S, et al. 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Kansenshogaku Zasshi. 1979;53:66\u201374.","journal-title":"Kansenshogaku Zasshi"},{"key":"535_CR7","doi-asserted-by":"publisher","first-page":"5107","DOI":"10.1128\/AAC.00701-15","volume":"59","author":"Y Matsumura","year":"2015","unstructured":"Matsumura Y, Yamamoto M, Nagao M, Komori T, Fujita N, Hayashi A, et al. Multicenter retrospective study of cefmetazole and Flomoxef for treatment of extended-spectrum-\u03b2-lactamase-producing Escherichia coli bacteremia. Antimicrob Agents Chemother. 2015;59:5107\u201313.","journal-title":"Antimicrob Agents Chemother"},{"key":"535_CR8","doi-asserted-by":"publisher","first-page":"e0051023","DOI":"10.1128\/aac.00510-23","volume":"67","author":"K Hayakawa","year":"2023","unstructured":"Hayakawa K, Matsumura Y, Uemura K, Tsuzuki S, Sakurai A, Tanizaki R, et al. Effectiveness of cefmetazole versus meropenem for invasive urinary tract infections caused by extended-spectrum \u03b2-lactamase-producing bacteria. Antimicrob Agents Chemother. 2023;67:e0051023.","journal-title":"Antimicrob Agents Chemother"},{"key":"535_CR9","doi-asserted-by":"publisher","first-page":"e159","DOI":"10.1016\/j.ijid.2012.09.010","volume":"17","author":"A Doi","year":"2013","unstructured":"Doi A, Shimada T, Harada S, Iwata K, Kamiya T. The efficacy of cefmetazole against pyelonephritis caused by extended-spectrum \u03b2-lactamase-producing Enterobacteriaceae. Int J Infect Dis. 2013;17:e159\u201363.","journal-title":"Int J Infect Dis"},{"key":"535_CR10","volume-title":"The Sanford guide to antimicrobial therapy 2023","author":"DN Gilbert","year":"2023","unstructured":"Gilbert DN, Boucher HW, Saag MS, Pavia AT, Freedman DO, Black D, et al. The Sanford guide to antimicrobial therapy 2023. 53rd ed. New York: Life Science Publishing; 2023.","edition":"53"},{"key":"535_CR11","doi-asserted-by":"crossref","unstructured":"Tamma PD, Aitken SL, Bonomo RA, Mathers AJ, van Duin D, Clancy CJ. Infectious diseases society of America 2023 guidance on the treatment of antimicrobial resistant gram-negative infections. Clin Infect Dis. 2023:ciae403:1\u201353.","DOI":"10.1093\/cid\/ciad428"},{"key":"535_CR12","doi-asserted-by":"publisher","first-page":"1602","DOI":"10.1016\/j.jiac.2021.07.009","volume":"27","author":"Y Hamada","year":"2021","unstructured":"Hamada Y, Matsumura Y, Nagashima M, Akazawa T, Doi Y, Hayakawa K. Retrospective evaluation of appropriate dosing of cefmetazole for invasive urinary tract infection due to extended-spectrum \u03b2-lactamase-producing Escherichia coli. J Infect Chemother. 2021;27:1602\u20136.","journal-title":"J Infect Chemother"},{"key":"535_CR13","doi-asserted-by":"publisher","first-page":"456","DOI":"10.3390\/antibiotics11040456","volume":"11","author":"Y Hamada","year":"2022","unstructured":"Hamada Y, Kasai H, Suzuki-Ito M, Matsumura Y, Doi Y, Hayakawa K. 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Antimicrob Agents Chemother. 1989;33:356\u201361.","journal-title":"Antimicrob Agents Chemother"}],"container-title":["Journal of Pharmaceutical Health Care and Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40780-025-00535-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40780-025-00535-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40780-025-00535-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T15:50:28Z","timestamp":1781625028000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s40780-025-00535-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,27]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["535"],"URL":"https:\/\/doi.org\/10.1186\/s40780-025-00535-1","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-6736302\/v1","asserted-by":"object"}]},"ISSN":["2055-0294"],"issn-type":[{"value":"2055-0294","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,27]]},"assertion":[{"value":"24 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Gifu Pharmaceutical University (Approval No. 5\u201313) and the Ethics Review Committee of Gifu Prefectural General Medical Center (Approval No. 758-4). Written informed consent was obtained from all participants or their substitute decision-makers prior to enrollment.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"12"}}