{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:38:55Z","timestamp":1760146735993,"version":"build-2065373602"},"reference-count":36,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background\/Objectives: Although chronic infection by Pseudomonas aeruginosa among patients with bronchiectasis is associated with poor prognosis, the impact of antibiotics with P. aeruginosa coverage in patients with bronchiectasis who experienced bacterial pneumonia or exacerbation of bronchiectasis has not been fully investigated. Methods: This study targeted patients with bronchiectasis who were admitted to hospitals because of bacterial pneumonia or exacerbation of bronchiectasis between April 2018 and March 2020 using a national inpatient database in Japan. The association of antipseudomonal antibiotic treatment with in-hospital mortality was assessed after propensity score matching to adjust the patients\u2019 backgrounds. Results: In total, 4943 patients with bacterial pneumonia and 1914 patients with exacerbation of bronchiectasis were included in this study. The in-hospital mortality rate did not differ between patients who did and did not receive antipseudomonal agents among patients with bacterial pneumonia (9.0% [185\/2045] vs. 7.4% [151\/2045]; p = 0.053) and those with exacerbation of bronchiectasis (5.2% [42\/803] vs. 4.1% [33\/803] group; p = 0.287). Conclusions: The use of antibiotics covering P. aeruginosa does not apparently improve prognosis in patients with bacterial pneumonia or exacerbation of bronchiectasis. A prospective study focusing on the impact of antibiotics covering P. aeruginosa among patients with bronchiectasis in whom P. aeruginosa is isolated is required.<\/jats:p>","DOI":"10.3390\/antibiotics13121182","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T06:24:44Z","timestamp":1733379884000},"page":"1182","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Antipseudomonal Antibiotics in Patients with Bronchiectasis Who Experienced Exacerbation or Developed Pneumonia: A Nationwide Study in Japan"],"prefix":"10.3390","volume":"13","author":[{"given":"Akihiko","family":"Hagiwara","sequence":"first","affiliation":[{"name":"Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu 879-5593, Oita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0977-7871","authenticated-orcid":false,"given":"Hisayuki","family":"Shuto","sequence":"additional","affiliation":[{"name":"Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu 879-5593, Oita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryohei","family":"Kudoh","sequence":"additional","affiliation":[{"name":"Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu 879-5593, Oita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1407-9779","authenticated-orcid":false,"given":"Shota","family":"Omori","sequence":"additional","affiliation":[{"name":"Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu 879-5593, Oita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazufumi","family":"Hiramatsu","sequence":"additional","affiliation":[{"name":"Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu 879-5593, Oita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun-ichi","family":"Kadota","sequence":"additional","affiliation":[{"name":"Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu 879-5593, Oita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1894-0290","authenticated-orcid":false,"given":"Kiyohide","family":"Fushimi","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8679-1661","authenticated-orcid":false,"given":"Kosaku","family":"Komiya","sequence":"additional","affiliation":[{"name":"Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu 879-5593, Oita, Japan"},{"name":"Research Center for GLOBAL and LOCAL Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu 879-5593, Oita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1056\/NEJMra2202819","article-title":"Bronchiectasis\u2014A Clinical Review","volume":"387","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1111\/resp.12832","article-title":"Aetiology of bronchiectasis in adults: A systematic literature review","volume":"21","author":"Gao","year":"2016","journal-title":"Respirology"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Chandrasekaran, R., Mac Aog\u00e1in, M., Chalmers, J.D., Elborn, S.J., and Chotirmall, S.H. (2018). Geographic variation in the aetiology, epidemiology and microbiology of bronchiectasis. BMC Pulm. Med., 18.","DOI":"10.1186\/s12890-018-0638-0"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/S2213-2600(23)00093-0","article-title":"Bronchiectasis in Europe: Data on disease characteristics from the European Bronchiectasis registry (EMBARC)","volume":"11","author":"Chalmers","year":"2023","journal-title":"Lancet Respir. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1111\/resp.14059","article-title":"Characteristics of bronchiectasis in Korea: First data from the Korean Multicentre Bronchiectasis Audit and Research Collaboration registry and comparison with other international registries","volume":"26","author":"Lee","year":"2021","journal-title":"Respirology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1164\/rccm.202307-1165OC","article-title":"Five-Year Outcomes among U.S. Bronchiectasis and NTM Research Registry Patients","volume":"210","author":"Aksamit","year":"2024","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_7","first-page":"A4370","article-title":"Etiology and health-related quality of life in non-cystic fibrosis bronchiectasis and nontuberculous mycobacterial pulmonary disease: The first analysis of the Japanese Nontuberculous Mycobacteriosis-Bronchiectasis Registry","volume":"201","author":"Asakura","year":"2020","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1183\/13993003.01033-2015","article-title":"Changes in the incidence, prevalence and mortality of bronchiectasis in the UK from 2004 to 2013: A population-based cohort study","volume":"47","author":"Quint","year":"2016","journal-title":"Eur. Respir. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1513\/AnnalsATS.201511-740PS","article-title":"Bronchiectasis in China","volume":"13","author":"Lin","year":"2016","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1378\/chest.10-0099","article-title":"Trends and burden of bronchiectasis-associated hospitalizations in the United States, 1993\u20132006","volume":"138","author":"Seitz","year":"2010","journal-title":"Chest"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1183\/13993003.00954-2015","article-title":"Bronchiectasis in Germany: A population-based estimation of disease prevalence","volume":"46","author":"Ringshausen","year":"2015","journal-title":"Eur. Respir. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1700629","DOI":"10.1183\/13993003.00629-2017","article-title":"European Respiratory Society guidelines for the management of adult bronchiectasis","volume":"50","author":"Polverino","year":"2017","journal-title":"Eur. Respir. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/thoraxjnl-2018-212468","article-title":"Updated BTS Adult Bronchiectasis Guideline 2018: A multidisciplinary approach to comprehensive care","volume":"74","author":"Hill","year":"2019","journal-title":"Thorax"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1016\/S2213-2600(20)30557-9","article-title":"The sputum microbiome and clinical outcomes in patients with bronchiectasis: A prospective observational study","volume":"9","author":"Dicker","year":"2021","journal-title":"Lancet Respir. Med."},{"key":"ref_15","first-page":"1602","article-title":"A Comprehensive Analysis of the Impact of Pseudomonas aeruginosa Colonization on Prognosis in Adult Bronchiectasis","volume":"12","author":"Finch","year":"2015","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/j.jgar.2020.04.021","article-title":"Is antipseudomonal antibiotic treatment needed for all nursing and healthcare-associated pneumonia patients at risk for antimicrobial resistance?","volume":"22","author":"Ito","year":"2020","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.jiac.2016.03.003","article-title":"Prospective open-label randomized comparative, non-inferiority study of two initial antibiotic strategies for patients with nursing- and healthcare-associated pneumonia: Guideline-concordant therapy versus empiric therapy","volume":"22","author":"Matsuda","year":"2016","journal-title":"J. Infect. Chemother."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"705","DOI":"10.2147\/IJGM.S271301","article-title":"Clinical Benefits of Piperacillin\/Tazobactam versus a Combination of Ceftriaxone and Clindamycin in the Treatment of Early, Non-Ventilator, Hospital-Acquired Pneumonia in a Community-Based Hospital","volume":"13","author":"Park","year":"2020","journal-title":"Int. J. Gen. Med."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"American Thoracic Society, and Infectious Diseases Society of America (2005). Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am. J. Respir. Crit. Care Med., 171, 388\u2013416.","DOI":"10.1164\/rccm.200405-644ST"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1164\/rccm.201908-1581ST","article-title":"Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America","volume":"200","author":"Metlay","year":"2019","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.jiac.2022.09.016","article-title":"Impact of Pseudomonas aeruginosa coverage on the prognosis of elderly patients with community-acquired pneumonia","volume":"29","author":"Goto","year":"2023","journal-title":"J. Infect. Chemother."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1016\/j.jiac.2022.04.012","article-title":"Methicillin-resistant Staphylococcus aureus among elderly patients with community-acquired pneumonia","volume":"28","author":"Goto","year":"2022","journal-title":"J. Infect. Chemother."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Richardson, H., Dicker, A.J., Barclay, H., and Chalmers, J.D. (2019). The microbiome in bronchiectasis. Eur. Respir. Rev., 28.","DOI":"10.1183\/16000617.0048-2019"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Concei\u00e7\u00e3o, M., Shteinberg, M., Goeminne, P., Altenburg, J., and Chalmers, J.D. (2024). Eradication treatment for Pseudomonas aeruginosa infection in adults with bronchiectasis: A systematic review and meta-analysis. Eur. Respir. Rev., 33.","DOI":"10.1183\/16000617.0178-2023"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1164\/rccm.201301-0079OC","article-title":"Risk factors for drug-resistant pathogens in community-acquired and healthcare-associated pneumonia","volume":"188","author":"Shindo","year":"2013","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.ejim.2021.10.005","article-title":"Risk factors for community-onset pneumonia caused by drug-resistant pathogens: A prospective cohort study","volume":"96","author":"Barreto","year":"2022","journal-title":"Eur. J. Intern. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/S2213-2600(21)00277-0","article-title":"Criteria and definitions for the radiological and clinical diagnosis of bronchiectasis in adults for use in clinical trials: International consensus recommendations","volume":"10","author":"Aliberti","year":"2022","journal-title":"Lancet Respir. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1177\/1060028020935106","article-title":"Risk Factor Evaluation for Methicillin-Resistant Staphylococcus aureus and Pseudomonas aeruginosa in Community-Acquired Pneumonia","volume":"55","author":"Lewis","year":"2021","journal-title":"Ann. Pharmacother."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1111\/resp.12651","article-title":"Predictors of Pseudomonas and methicillin-resistant Staphylococcus aureus in hospitalized patients with healthcare-associated pneumonia","volume":"21","author":"Metersky","year":"2016","journal-title":"Respirology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2188\/jea.JE20200288","article-title":"History and Profile of Diagnosis Procedure Combination (DPC): Development of a Real Data Collection System for Acute Inpatient Care in Japan","volume":"31","author":"Hayashida","year":"2021","journal-title":"J. Epidemiol."},{"key":"ref_31","unstructured":"(2024, September 29). Central Social Insurance Medical Council (the Central Social Insurance Medical Council Medical Service Fee Investigation Professional Organization (DPC Evaluation Subcommittee Meeting)). Available online: https:\/\/www.mhlw.go.jp\/stf\/shingi\/shingi-chuo_128164.html."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Hagiwara, A., Shuto, H., Kudoh, R., Omori, S., Hiramatsu, K., Kadota, J.I., Fushimi, K., and Komiya, K. (2024). Medical Causes of Hospitalisation among Patients with Bronchiectasis: A Nationwide Study in Japan. Pathogens, 13.","DOI":"10.3390\/pathogens13060492"},{"key":"ref_33","unstructured":"Weir, C.B., and Jan, A. (2024). BMI Clsassification Percentile and Cut off Points, StatPearls."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"531","DOI":"10.2188\/jea.JE20220147","article-title":"Development and Validation of a Novel Method for Converting the Japan Coma Scale to Glasgow Coma Scale","volume":"33","author":"Nakajima","year":"2023","journal-title":"J. Epidemiol."},{"key":"ref_35","unstructured":"The Japanese Respiratory Society (2024). The JRS Guidelines for the Management of Pneumonia in Adults 2024, The Japanese Respiratory Society."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Tamma, P.D., Heil, E.L., Justo, J.A., Mathers, A.J., Satlin, M.J., and Bonomo, R.A. (2024). Infectious Diseases Society of America 2024 Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections. Clin. Infect. Dis.","DOI":"10.1093\/cid\/ciae403"}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/13\/12\/1182\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:47:30Z","timestamp":1760114850000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/13\/12\/1182"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,5]]},"references-count":36,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["antibiotics13121182"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics13121182","relation":{},"ISSN":["2079-6382"],"issn-type":[{"type":"electronic","value":"2079-6382"}],"subject":[],"published":{"date-parts":[[2024,12,5]]}}}