Penicillin allergy labels are common among hospitalized patients, yet most represent inaccurate or nonimmune-mediated reactions and may contribute to suboptimal antibiotic prescribing. This systematic review aimed to evaluate the effectiveness and safety of hospital-based penicillin allergy delabeling interventions and their impact on antibiotic prescribing. PubMed/MEDLINE, CENTRAL, Scopus, and Web of Science were systematically searched up to January 2026. Additional records were identified through ClinicalTrials.gov and citation tracking. Eligible studies included hospitalized patients with documented penicillin or β-lactam allergy labels who underwent structured delabeling interventions with a comparator group. Given substantial heterogeneity in study design, interventions, and outcomes, findings were synthesized narratively. Nine studies were included (three randomized controlled trials and six nonrandomized studies). Delabeling success rates ranged from approximately 4
Prescriptions of angiotensin receptor neprilysin inhibitor (ARNI) have increased in recent years; however, few pharmacovigilance studies have investigated acute kidney injury (AKI) reporting associated with ARNI. This study evaluated the disproportionate AKI reporting associated with ARNI in the Japanese Adverse Drug Event Report (JADER) database, compared AKI reporting between reports involving ARNI and valsartan, and explored the factors associated with AKI reporting among reports involving ARNI. Reports published in JADER between April 2020 and August 2023 were analyzed. AKI was identified using the narrow and broad scope Preferred Terms of the Standardized MedDRA Query (SMQ) “acute renal failure” (SMQ:20000003). The reporting odds ratios (RORs) and 95
Eluxadoline is a US Food and Drug Administration-approved therapy for irritable bowel syndrome with diarrhea and has important contraindications that may influence uptake in older adults. Medicare Part D dispensing patterns remain poorly characterized. This study aimed to characterize national and state-level trends in eluxadoline dispensing and spending in Medicare Part D from 2016–2023, including geographic variation in population-adjusted rates and differences in dispensing intensity by prescriber type. We conducted a retrospective repeated cross-sectional analysis using Centers for Medicare Medicaid Services Medicare Part D Prescribers-by Provider and Drug Public Use Files from 2016 to 2023. Utilization was summarized using standardized 30-day fills (primary) and claims (secondary); state intensity was measured as fills per 100,000 Part D utilizers. Geographic concentration and outliers in state rates were assessed using Gini coefficients and median absolute deviation-based outlier detection. Prescriber-type differences in dispensing intensity were evaluated with negative binomial models of claims with National Provider Identifier-clustered standard errors. The Public Use Files contained 7826 prescriber-year observations from 3866 prescribers. National 30-day fills rose from 4410.9 (2016) to 19,860.2 (2018) and declined to 15,326.0 (2023). Median state rates increased from 7.3 per 100,000 (2016) to 43.7 (2018) and were 27.6–35.9 in 2019–23; California, Texas, New Jersey, New York, and Florida accounted for 39.5
Polypharmacy is highly prevalent among older patients undergoing cerebrovascular rehabilitation and may adversely affect functional recovery. This study examined the association between polypharmacy and the extent and pace of functional recovery in older patients undergoing convalescent rehabilitation after cerebrovascular events. This retrospective observational study used a Japanese real-world claims database (Japan Medical Data Center claims database, accessed on 25 August 2025), and included patients aged ≥ 65 years admitted to convalescent rehabilitation wards for cerebrovascular diseases. Polypharmacy was defined as the use of six or more medications. Patients were categorized into four groups according to polypharmacy status at admission and discharge: persistent non-polypharmacy, polypharmacy resolved, incident polypharmacy, and persistent polypharmacy. Functional outcomes were assessed using the Functional Independence Measure (FIM). The primary outcome measure was FIM gain, and the secondary outcome measure was FIM efficiency. Multivariable linear regression analyses adjusted for patient characteristics, comorbidities, and hospital bed capacity were performed. Among 44,980 patients, 48.9
Ulcerative colitis (UC) and Crohn’s disease (CD) are chronic immune-mediated conditions associated with a substantial clinical and economic burden. Italian epidemiological evidence is limited. Mesalazine remains a cornerstone of UC management. This study aimed to provide updated epidemiological estimates of inflammatory bowel disease (IBD) in Italy, and to evaluate real-world treatment patterns, adherence to oral mesalazine, and healthcare costs among patients with UC initiating mesalazine therapy. A retrospective observational analysis was conducted using Italian administrative databases covering 4 million beneficiaries. Patients with UC and CD were identified (January 2010–May 2023) using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) or exemption codes. Patients with UC who were new users of mesalazine were characterized at baseline. Mesalazine treatment patterns, adherence, and direct healthcare costs were described at follow-up. At the end of 2023, UC and CD prevalence rates were 272 (95
