Publications by authors named "Chih-Cheng Lai"

412 Publications

Appropriate use of antimicrobial therapy for COVID-19 co-infection.

Immunotherapy 2021 Jun 11. Epub 2021 Jun 11.

Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan.

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http://dx.doi.org/10.2217/imt-2021-0134DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8202506PMC
June 2021

The association between inhaled corticosteroid and osteoporosis and fracture.

Eur Respir J 2021 Jun 4;57(6). Epub 2021 Jun 4.

Dept of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan

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http://dx.doi.org/10.1183/13993003.00216-2021DOI Listing
June 2021

Clinical efficacy and safety of baloxavir marboxil in the treatment of influenza: A systematic review and meta-analysis of randomized controlled trials.

J Microbiol Immunol Infect 2021 Apr 29. Epub 2021 Apr 29.

Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan. Electronic address:

Purpose: The aim of this meta-analysis is to compare the clinical efficacy and safety of baloxavir with other anti-influenza agents or placebo in the treatment of influenza.

Methods: PubMed, Embase, Web of Science, Google Scholar, Scopus, CINAHL, Cochrane databases and clinical registration were searched from inception until February 15 2021 for relevant randomized controlled trials (RCTs). Only phase 3 RCTs evaluating the usefulness of baloxavir in the treatment of influenza were included.

Results: Three RCTs enrolling 3771 patients (baloxavir group, n = 1451; oseltamivir group, n = 1288; placebo group, n = 1032) were included. Compared with oseltamivir, baloxavir had an insignificantly shorter time to the alleviation of symptoms (mean difference [MD], -1.29 h; 95% CI, -6.80 to 4.21; I = 0%). In contrast, baloxavir had a significantly shorter time to the alleviation of symptoms than placebo (MD, -26.32 h; 95% CI, -33.78 to -18.86; I = 0%). Baloxavir was associated with a significant decline in influenza virus titers and viral RNA load compared to oseltamivir and placebo. Baloxavir was associated with a lower risk of any adverse events than oseltamivir (OR, 0.82; 95% CI, 0.69-0.98; I = 0%) and placebo (OR, 0.79; 95% CI, 0.66-0.96; I = 0%).

Conclusions: The findings of this meta-analysis suggested that baloxavir is superior to placebo in the treatment of influenza in both clinical outcome and virological response. Moreover, baloxavir was found to have a better virological response than oseltamivir and to be as effective as oseltamivir clinically. Compared with oseltamivir and placebo, baloxavir appears to be a relatively safe anti-influenza agent.
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http://dx.doi.org/10.1016/j.jmii.2021.04.002DOI Listing
April 2021

The effect on combination therapy and antibiotic duration.

Clin Infect Dis 2021 May 16. Epub 2021 May 16.

Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan.

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http://dx.doi.org/10.1093/cid/ciab388DOI Listing
May 2021

The safety of nintedanib for the treatment of interstitial lung disease: A systematic review and meta-analysis of randomized controlled trials.

PLoS One 2021 14;16(5):e0251636. Epub 2021 May 14.

Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan.

Introduction: Nintedanib can inhibit processes involved in the progression of fibrosis and can reduce the decline in forced vital capacity in patients with idiopathic pulmonary fibrosis (IPF) and fibrotic-interstitial lung disease (fibrotic-ILDs). Although the adverse events associated with nintedanib in IPF patients are well known, its safety in other fibrotic-ILD patients remained unclear.

Methods: We searched PubMed, EMBASE, Cochrane CENTRAL and Cochrane CDSR for randomized controlled studies which compared nintedanib with a placebo in ILD patients. We estimated pooled odds ratios (ORs) and 95% confidence intervals (CIs) for adverse events using the DerSimonian-Laird random-effects model.

Results: Six studies with a total of 2,583 patients were included in the meta-analysis. The pooled estimates showed that patients treated with nintedanib had a significantly higher likelihood of having any adverse events (OR = 2.39; 95% CI = 1.71-3.36) or adverse events leading to treatment discontinuation (OR = 1.73; 95% CI = 1.34-2.25). However, they had trend to lower likelihood of having fatal adverse events (OR = 0.69; 95% CI = 0.41-1.14) compared with the placebo group. Use of nintedanib was positively associated with diarrhea (OR = 5.96; 95% CI = 4.35-8.16), nausea (OR = 3.00; 95% CI = 1.93-4.66), vomiting (OR = 3.22; 95% CI = 2.17-4.76) and weight loss (OR = 3.38; 95% CI = 1.1.76-6.47). Whereas, patients treated with nintedanib were less likely to have a cough (OR = 0.73; 95% CI = 0.56-0.96) and dyspnea (OR = 0.70; 95% CI = 0.53-0.94).

Conclusions: Compared to a placebo, nintedanib was associated with a higher risk of adverse events, especially for diarrhea, nausea, vomiting and weight loss, but it was also associated with a lower risk of cough and dyspnea in IPF and fibrotic-ILD patients.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0251636PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121296PMC
May 2021

Clinical efficacy and safety of ceftobiprole in the treatment of acute bacterial skin and skin structure infection: a systematic review and meta-analysis of randomized controlled trials.

Expert Rev Anti Infect Ther 2021 Jun 15:1-8. Epub 2021 Jun 15.

Department of Orthopedic, Chi Mei Medical Center, Tainan Taiwan.

: To investigate the clinical efficacy and safety of ceftobiprole for acute bacterial skin and skin structure infections (ABSSSIs).: PubMed, Web of Science, EBSO, Ovid Medline, ClinicalTrial.gov and Cochrane Library were searched until 25 December 2020. Only randomized controlled trials that compared the treatment efficacy of ceftobiprole with that of other antibiotics for adult patients with ABSSSIs were included in this meta-analysis.: The 3 RCTs involving 2291 adult patients with ABSSSIs were included. No significant difference in clinical success, as measured by the TOC, was observed between ceftobiprole and comparators among the intention-to-treat population (OR, 1.06; 95% CI, 0.85-1.33;  = 0%) and clinical evaluable population (OR, 1.17; 95% CI, 0.76-1.79;  = 17%). Ceftobiprole was associated with a similar risk of adverse events (AEs) to that of comparators.: Ceftobiprole can achieve similar clinical and microbiological responses as alternative antibiotics in patients with ABSSSIs. In addition, ceftobiprole shares a similar safety profile to comparators.
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http://dx.doi.org/10.1080/14787210.2021.1927711DOI Listing
June 2021

Klebsiella pneumoniae Harboring Carbapenemase Genes in Taiwan: Its Evolution over 20 Years, 1998-2019.

Int J Antimicrob Agents 2021 May 6:106354. Epub 2021 May 6.

Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan; Department of Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address:

Klebsiella pneumoniae (K. pneumoniae) is an important pathogen causing various types of human infections in Taiwan. Carbapenemases have increasingly been reported in Enterobacterales in the past two decades. Carbapenemase-producing K. pneumoniae (CPKP), a major resistance concern that has emerged during the last decade, has become a global threat, with its related infections associated with high morbidity and mortality; however, therapeutic options for CPKP-associated infections are limited. Carbapenemases - including K. pneumoniae carbapenemases (KPC)-2, New Delhi metallo-β-lactamase (NDM)-1, Verona integron-encoded metallo-β-lactamase (VIM)-1, imipenemase (IMP)-1, and oxacillinase (OXA)-48 - have been reported worldwide, with a marked prevalence in different countries or areas of the world. Understanding the epidemiology of carbapenemase producers is important for the prevention of their expansion. This review examined the evolution of CPKP in the last two decades to better understand the role of CPKP in Taiwan. It discovered that the endemicity has changed from IMP-8, NDM-1 and VIM-1 to the most common KPC-2 and rapidly emerging OXA-48. Resistance epidemiology, genetic background, virulence factors, therapy, and outcomes are discussed in this paper.
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http://dx.doi.org/10.1016/j.ijantimicag.2021.106354DOI Listing
May 2021

The prevalence and outcome of short-acting β2-agonists overuse in asthma patients in Taiwan.

NPJ Prim Care Respir Med 2021 Apr 20;31(1):19. Epub 2021 Apr 20.

Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.

This study aims to investigate the prevalence of short-acting β2-agonist (SABA) overuse in asthma and the associated risk of acute exacerbation and mortality in Taiwan. We used the Taiwanese pay-for-performance asthma program database, which included patients aged between 12 and 100 years who were enrolled in the program between 2001 and 2015. Among a total of 218,039 patients, 34,641 (15.9%) patients are classified as SABA over-users. Compared with patients who did not receive inhaled corticosteroids (ICS) and collected ≤2 canisters, SABA over-users had a higher risk of severe exacerbations. SABA over-users had a higher risk of all-cause mortality compared with patients who did not receive ICS and collected ≤2 canisters. The overall prevalence of SABA overuse in Taiwan is 15.9%, and this is even higher in concomitant ICS users. In addition, the overuse of SABA is associated with an increased risk of severe exacerbation and death.
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http://dx.doi.org/10.1038/s41533-021-00231-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058069PMC
April 2021

The effect of tocilizumab on COVID-19 patient mortality: A systematic review and meta-analysis of randomized controlled trials.

Int Immunopharmacol 2021 Mar 24;96:107602. Epub 2021 Mar 24.

Division of Pulmonary, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan. Electronic address:

Objectives: This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to investigate the clinical efficacy and safety of tocilizumab for treating patients with COVID-19.

Methods: The PubMed, Embase, Cochrane Library, Clinicaltrials.gov, WHO International Clinical Trials Registry Platform and the preprint server of medRxiv.org were searched from their inception to February 20, 2021. Only RCTs that compared the treatment efficacy and safety of tocilizumab with the placebo or the standard of care for adult patients with COVID-19 were included in this meta-analysis. The primary outcome was 28-day mortality.

Results: This meta-analysis included eight RCTs which enrolled a total of 6314 patients for randomization, in which 3267 and 3047 patients were assigned to the tocilizumab and control groups, respectively. The mortality at day 28 was 24.4% and 29.9% in patients in the tocilizumab and control groups, respectively, meaning there was no significant difference observed between these two groups (OR, 0.92; 95% CI, 0.66-1.28; I = 62). This finding did not change in the subgroup analysis according to the initial use of MV or steroid while enrollment. The patients receiving tocilizumab had a lower rate of mechanical ventilation (MV) and intensive care unit (ICU) admission at day 28 compared with the control group (MV use: OR, 0.75; 95% CI, 0.62-0.90; I = 11; ICU admission: OR, 0.51; 95% CI, 0.28-0.92; I = 30). There were no significant differences between these two treatment groups in terms of the risk of treatment-emergent adverse events (AEs) (OR, 1.03; 95% CI, 0.71-1.49; I = 43), serious AEs (OR, 0.86; 95% CI, 0.67-1.12; I = 0) or infection (OR, 0.87; 95% CI, 0.63-1.20; I = 0).

Conclusions: Tocilizumab does not provide a survival benefit for patients with COVID-19, but it may help reduce the risk of MV and ICU admission. In addition, tocilizumab is a safe agent to use for the treatment of COVID-19.
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http://dx.doi.org/10.1016/j.intimp.2021.107602DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7988468PMC
March 2021

Association of fluoroquinolones use with the risk of aortic aneurysm or aortic dissection: Facts and myths.

J Microbiol Immunol Infect 2021 Apr 14;54(2):182-184. Epub 2021 Mar 14.

Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address:

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http://dx.doi.org/10.1016/j.jmii.2021.03.002DOI Listing
April 2021

Clinical efficacy and safety of remdesivir in patients with COVID-19: a systematic review and network meta-analysis of randomized controlled trials.

J Antimicrob Chemother 2021 Mar 24. Epub 2021 Mar 24.

Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.

Objectives: We performed a systematic review and network meta-analysis of randomized controlled trials (RCTs) to provide updated information regarding the clinical efficacy of remdesivir in treating coronavirus disease 2019 (COVID-19).

Methods: PubMed, Embase, Cochrane Library, clinical trial registries of ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform were searched for relevant articles published up to 18 November 2020.

Results: Five RCTs, including 13 544 patients, were included in this meta-analysis. Among them, 3839 and 391 patients were assigned to the 10 day and 5 day remdesivir regimens, respectively. Patients receiving 5 day remdesivir therapy presented greater clinical improvement than those in the control group [OR = 1.68 (95% CI 1.18-2.40)], with no significant difference observed between the 10 day and placebo groups [OR = 1.23 (95% CI 0.90-1.68)]. Patients receiving remdesivir revealed a greater likelihood of discharge [10 day remdesivir versus control: OR = 1.32 (95% CI 1.09-1.60); 5 day remdesivir versus control: OR = 1.73 (95% CI 1.28-2.35)] and recovery [10 day remdesivir versus control: OR = 1.29 (95% CI 1.03-1.60); 5 day remdesivir versus control: OR = 1.80 (95% CI 1.31-2.48)] than those in the control group. In contrast, no mortality benefit was observed following remdesivir therapy. Furthermore, no significant association was observed between remdesivir treatment and an increased risk of adverse events.

Conclusions: Remdesivir can help improve the clinical outcome of hospitalized patients with COVID-19 and a 5 day regimen, instead of a 10 day regimen, may be sufficient for treatment. Moreover, remdesivir appears as tolerable as other comparators or placebo.
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http://dx.doi.org/10.1093/jac/dkab093DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083728PMC
March 2021

Increased antimicrobial resistance during the COVID-19 pandemic.

Int J Antimicrob Agents 2021 Apr 19;57(4):106324. Epub 2021 Mar 19.

Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address:

In addition to SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection itself, an increase in the incidence of antimicrobial resistance poses collateral damage to the current status of the COVID-19 (coronavirus disease 2019) pandemic. There has been a rapid increase in multidrug-resistant organisms (MDROs), including extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae, carbapenem-resistant New Delhi metallo-β-lactamase (NDM)-producing Enterobacterales, Acinetobacter baumannii, methicillin-resistant Staphylococcus aureus (MRSA), pan-echinocandin-resistant Candida glabrata and multi-triazole-resistant Aspergillus fumigatus. The cause is multifactorial and is particularly related to high rates of antimicrobial agent utilisation in COVID-19 patients with a relatively low rate of co- or secondary infection. Appropriate prescription and optimised use of antimicrobials according to the principles of antimicrobial stewardship as well as quality diagnosis and aggressive infection control measures may help prevent the occurrence of MDROs during this pandemic.
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http://dx.doi.org/10.1016/j.ijantimicag.2021.106324DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972869PMC
April 2021

The impact of COVID-19 control measures on the utilization of emergency department during lunar new year in Taiwan.

Am J Emerg Med 2021 05 12;43:252-254. Epub 2021 Mar 12.

Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan. Electronic address:

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http://dx.doi.org/10.1016/j.ajem.2021.03.027DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7952148PMC
May 2021

The impact of the coronavirus disease 2019 epidemic on notifiable infectious diseases in Taiwan: A database analysis.

Travel Med Infect Dis 2021 Mar-Apr;40:101997. Epub 2021 Feb 25.

Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address:

Introduction: The impact of the COVID-19 pandemic on the incidence of notifiable infectious diseases (NIDs) in Taiwan remains unclear.

Materials And Methods: The number of cases of NID (n = 42) between January and September 2019 and 2020 were obtained from the open database from Taiwan Centers for Disease Control.

Results: The number of NID cases was 21,895 between January and September 2020, which was lower than the number of cases during the same period in 2019 (n = 24,469), with a decline in incidence from 102.9 to 91.7 per 100,000 people in 2019 and 2020, respectively. Fourteen airborne/droplet, 11 fecal-oral, seven vector-borne, and four direct-contact transmitted NID had an overall reduction of 2700 (-28.1%), 156 (-23.0%), 557 (-54.8%), and 73 (-45.9%) cases, respectively, from 2019 to 2020. Similar trends were observed for the changes in incidence, which were 11.5 (-28.4%), 6.7 (-23.4%), 2.4 (-55.0%), and 0.3 (-46.2%) per 100,000 people for airborne/droplet, fecal-oral, vector-borne, and direct-contact transmitted NID, respectively. In addition, all the 38 imported NID showed a reduction of 632 (-73.5%) cases from 2019 to 2020. In contrast, 4 sexually transmitted diseases (STDs) showed an increase of 903 (+7.2%) cases from 2019 to 2020, which was attributed to the increase in gonorrhea (from 3220 to 5028). The overall incidence of STDs increased from 52.5 to 56.0 per 100,000 people, with a percentage change of +6.7%.

Conclusion: This study demonstrated a collateral benefit of COVID-19 prevention measures for various infectious diseases, except STDs, in Taiwan, during the COVID-19 epidemic.
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http://dx.doi.org/10.1016/j.tmaid.2021.101997DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7905388PMC
April 2021

Clinical Efficacy and Safety of Cefoperazone-Sulbactam in Treatment of Intra-Abdominal Infections: A Systematic Review and Meta-Analysis.

Surg Infect (Larchmt) 2021 Feb 23. Epub 2021 Feb 23.

Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan.

In this systematic review and meta-analysis, we aimed to assess the clinical efficacy and safety of cefoperazone-sulbactam against alternative antibiotics in the treatment of intra-abdominal infections. The PubMed, Cochrane, Web of Science, Ovid Medline, and CKNI databases were searched for relevant articles up to November 25, 2020. The primary outcome was clinical efficacy rate, and the secondary outcomes were microbiologic eradication rate, mortality rate, and adverse event (AE) risk. Twelve studies involving 1,674 patients were included. Overall, the clinical efficacy rate of cefoperazone-sulbactam and comparators was 87.7% and 81.7%, respectively, and cefoperazone-sulbactam was associated with a higher clinical efficacy rate than that the comparator (odds ratio [OR] 1.98; 95% confidence interval [CI] 1.31-3.00;  = 36%). Additionally, cefoperazone-sulbactam was associated with a lower clinical failure rate (OR 0.40; 95% CI 0.28-0.57;  = 0) and a higher clinical cure rate (OR 1.54; 95% CI 1.17-2.03;  = 0) than the comparators. Cefoperazone-sulbactam was associated with a higher microbiologic eradication rate than the comparator (OR 2.54; 95% CI 1.72-3.76;  = 0). Finally, there was no significant difference between cefoperazone-sulbactam and the comparators in terms of mortality rate (OR 090; 95% CI 0.38-2.16;  = 0) and AE risk (OR 1.07; 95% CI 0.74-1.55;  = 0). The clinical efficacy and safety of cefoperazone-sulbactam were similar to those of alternative antibiotics in the treatment of intra-abdominal infections. Therefore, cefoperazone-sulbactam could be recommended as an effective and safe antibiotic for treating intra-abdominal infections.
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http://dx.doi.org/10.1089/sur.2020.468DOI Listing
February 2021

How to Keep COVID-19 at Bay: A Taiwanese Perspective.

J Epidemiol Glob Health 2021 03 4;11(1):1-5. Epub 2020 Nov 4.

Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.

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http://dx.doi.org/10.2991/jegh.k.201028.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7958278PMC
March 2021

Clinical efficacy and safety of cefiderocol in the treatment of acute bacterial infections: A systematic review and meta-analysis of randomised controlled trials.

J Glob Antimicrob Resist 2021 Mar 15;24:376-382. Epub 2021 Feb 15.

Division of Pulmonary, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan. Electronic address:

Objectives: The aim of this study was to investigate the clinical efficacy and safety of cefiderocol in the treatment of acute bacterial infections.

Methods: The PubMed, Embase and Cochrane Library databases as well as the clinical trials registries of ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform were searched up to 8 November 2020. Only randomised controlled trials (RCTs) that compared the treatment efficacy of cefiderocol with that of other antibiotics for adult patients with acute bacterial infections were included in this meta-analysis. The primary outcome was clinical response at test of cure (TOC).

Results: Three RCTs, including one phase 2 and two phase 3 trials, were included. No significant difference in clinical response rate was observed between cefiderocol and comparators [odds ratio (OR)=1.04]. In a subgroup analysis, no significant difference was observed in the clinical response at TOC between cefiderocol and comparators in patients with nosocomial pneumonia (OR=0.92) or complicated urinary tract infection (OR=1.28). In addition, all-cause mortality at Days 14 and 28 did not differ between the cefiderocol and control groups (14-day mortality, OR=1.25; 28-day mortality, OR=1.12). Furthermore, cefiderocol was associated with similar microbiological response to comparators at the TOC assessment (OR=1.44). Finally, cefiderocol was associated with a similar risk of adverse events as comparators.

Conclusion: Cefiderocol can achieve similar clinical and microbiological responses as comparators for patients with serious bacterial infections. In addition, cefiderocol shares a safety profile similar to that of comparators.
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http://dx.doi.org/10.1016/j.jgar.2021.02.004DOI Listing
March 2021

Association between the use of statins and risk of tuberculosis: a real-world analysis.

J Infect Dis 2021 Feb 8. Epub 2021 Feb 8.

Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.

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http://dx.doi.org/10.1093/infdis/jiab077DOI Listing
February 2021

Clinical outcomes of ceftobiprole in the treatment of acute bacterial skin and skin structure infections.

J Glob Antimicrob Resist 2021 Mar 1;24:303-305. Epub 2021 Feb 1.

Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan. Electronic address:

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http://dx.doi.org/10.1016/j.jgar.2021.01.015DOI Listing
March 2021

Molecular characteristics and in vitro effects of antimicrobial combinations on planktonic and biofilm forms of Elizabethkingia anophelis.

J Antimicrob Chemother 2021 Apr;76(5):1205-1214

Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan.

Objectives: To investigate the in vitro activity of antibiotics against clinical Elizabethkingia anophelis isolates and to find a suitable antibiotic combination with synergistic effects to combat antibiotic-resistant E. anophelis and its associated biofilm.

Methods: E. anophelis isolates were identified by 16S rRNA sequencing; 30 strains with different pulsotypes were identified and the MIC, antibiotic resistance mechanism, antibiotic combination activity and killing effects of antimicrobial agents on biofilms of these strains were determined.

Results: All E. anophelis isolates were susceptible to minocycline and cefoperazone/sulbactam (1:1). More than 90% of clinical isolates were susceptible to cefoperazone/sulbactam (1:0.5), piperacillin/tazobactam and rifampicin. Some novel mutations, such as gyrA G81D, parE D585N and parC P134T, that have never been reported before, were identified. The synergistic effect was most prominent for the combination of minocycline and rifampicin, with 93.3% of their FIC index values ≤0.5, and no antagonism was observed using the chequerboard method. This synergistic effect between minocycline and rifampicin was also observed using time-killing methods for clinical E. anophelis isolates at both normal inoculum and high inoculum. Twenty-nine isolates tested positive for biofilm formation. Minocycline remained active against biofilm-embedded and biofilm-released planktonic E. anophelis cells; however, the enhanced effect of minocycline by adding rifampicin was only observed at 24 h (not at 72 and 120 h).

Conclusions: Although E. anophelis was resistant to many antibiotics and could exhibit biofilm formation, minocycline showed potent in vitro activity against this pathogen and its associated biofilm.
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http://dx.doi.org/10.1093/jac/dkab018DOI Listing
April 2021

Sofosbuvir/daclatasvir in the treatment of COVID-19 infection: A meta-analysis.

J Infect 2021 04 26;82(4):e34-e35. Epub 2020 Dec 26.

Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan, Branch, Tainan, Taiwan. Electronic address:

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http://dx.doi.org/10.1016/j.jinf.2020.12.021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7764469PMC
April 2021

Efficacy and safety of anti-interleukin-5 therapy in patients with chronic obstructive pulmonary disease: A meta-analysis of randomized, controlled trials.

J Microbiol Immunol Infect 2020 Dec 5. Epub 2020 Dec 5.

Department of Physiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address:

Background: Anti-interleukin-5 (IL-5) therapy has been proposed as a novel treatment option for patients with chronic obstructive pulmonary disease (COPD). However, its efficacy for preventing COPD exacerbation remains unclear.

Methods: A literature review was conducted to August 26th 2019. Only randomized controlled trials (RCTs) that investigated the clinical efficacy and adverse effects of anti-IL-5 therapy were included in the meta-analysis. The primary outcome was the risk of COPD exacerbation.

Results: A total of 3 articles containing 5 RCTs were included in the study. Overall, 2837 and 1442 patients received anti-IL-5 therapy (mepolizumab, n = 865; benralizumab, n = 1972) and placebo, respectively. In the pooled analysis, anti-IL-5 therapy was associated with a lower risk of COPD exacerbation compared with the placebo (rate ratio, 0.92; 95% CI, 0.86-0.97, I = 0%). In addition, no significant differences in the changes in SGRQ scores and FEV from baseline were found between the anti-IL-5 therapy and placebo (SGRQ, mean difference, -0.86, 95% CI, -1.92 - 0.19, I = 0%; FEV, mean difference, 0.01, 95% CI, -0.01 - 0.03, I = 0%). Anti-IL-5 therapy had a similar risk of any adverse event (risk ratio, 1.02; 95% CI, 0.99-1.05), an event leading to treatment discontinuation (risk ratio, 1.04; 95% CI, 0.72-1.48) and any serious adverse events (risk ratio, 0.93; 95% CI, 0.85-1.01) when compared with the placebo.

Conclusion: Anti-IL-5 therapy was associated with a lower rate of COPD exacerbation compared with placebo. In addition, anti-IL-5 therapy was well tolerated for COPD patients.
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http://dx.doi.org/10.1016/j.jmii.2020.11.001DOI Listing
December 2020

The safety of remdesivir for COVID-19 patients.

J Med Virol 2021 04 23;93(4):1910-1912. Epub 2020 Dec 23.

Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan.

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http://dx.doi.org/10.1002/jmv.26735DOI Listing
April 2021

A mysterious surge of aspergillosis among non-SARS-CoV-2 patients during COVID-19 pandemic.

J Microbiol Immunol Infect 2021 Feb 1;54(1):156-158. Epub 2020 Dec 1.

Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan; Department of Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address:

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http://dx.doi.org/10.1016/j.jmii.2020.11.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7706424PMC
February 2021

Clinical efficacy and safety of favipiravir in the treatment of COVID-19 patients.

J Infect 2021 05 7;82(5):186-230. Epub 2020 Dec 7.

Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan. Electronic address:

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http://dx.doi.org/10.1016/j.jinf.2020.12.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7721353PMC
May 2021

The impact of COVID-19 preventative measures on airborne/droplet-transmitted infectious diseases in Taiwan.

J Infect 2021 03 26;82(3):e30-e31. Epub 2020 Nov 26.

Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address:

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http://dx.doi.org/10.1016/j.jinf.2020.11.029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7690307PMC
March 2021

Impact of Tocilizumab on the Mortality of Patients With Coronavirus Disease 2019.

Clin Infect Dis 2021 Jun;72(12):e1156-e1157

Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan.

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http://dx.doi.org/10.1093/cid/ciaa1738DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7717218PMC
June 2021

Impact of COVID-19 preventative measures on dengue infections in Taiwan.

J Med Virol 2021 07 11;93(7):4063-4064. Epub 2021 Mar 11.

Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.

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http://dx.doi.org/10.1002/jmv.26650DOI Listing
July 2021

Zero measles after COVID-19 pandemic in Taiwan.

J Infect 2021 03 26;82(3):414-451. Epub 2020 Oct 26.

Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan. Electronic address:

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http://dx.doi.org/10.1016/j.jinf.2020.10.021DOI Listing
March 2021

Diagnoses of syphilis and HIV infection during the COVID-19 pandemic in Taiwan.

Sex Transm Infect 2021 06 20;97(4):319. Epub 2020 Oct 20.

Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan

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http://dx.doi.org/10.1136/sextrans-2020-054802DOI Listing
June 2021