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Objectives: The incidence of remdesivir-induced renal dysfunction has not been investigated until now. The present study explored the clinical factors and laboratory data that predict remdesivir-induced renal dysfunction. The subjects were COVID-19 patients and we determined the endpoint as dialysis or death within 29 days. Background status parameters included (1) estimated glomerular filtration rate < 30 ml/min/1.73 m2, (2) serum creatinine (SCr) ratios to baseline > 1.5, (3) SCr ratios to upper limits > 1.5, (4) alanine aminotransferase ratios to upper limits > 5, (5) administration days, (6) sex, (7) age, (8) height, (9) weight, (10) dexamethasone use, and (11) SARS-CoV-2 vaccination. Results: In a total of 490 patients, a multivariate analysis showed that status (2) (odds ratio [OR] 8.342, 95% confidence interval [CI] 1.589-43.788, P=0.012) and status (7) (OR 7.620, CI 1.181-49.169, P=0.033) at 72 years or more were significant factors for remdesivir-induced renal dysfunction. To monitor renal function after remdesivir administration in COVID-19 patients, SCr ratios to baseline may work better than those to the upper limits.

Background: To see how the COVID-19 pandemic influenced the 3-year use of parenteral antimicrobials, we attempted a historical control study. Main body: Materials were the electronic medical record on the use of a total of 33 antimicrobials. We compared antimicrobial use density (AUD) of pre-pandemic 1 year (PreY), the first pandemic year (Pan1Y), and the second pandemic year (Pan2Y). Our antimicrobial team monitored all in-patients and COVID-19 patients underwent clinical pathways with antivirals. Results: showed that in a total of 20,013 patients (7,534, 6,146, and 6,333 for PreY, Pan1Y, and Pan2Y), sepsis-3 was diagnosed in 152, 132, and 283 patients while Clostridioides difficile toxin tests were positive in 17, 5, and 7 patients, respectively. Among patients with COVID-19 (N=622) at a median age of 58 (range, 1-99), 11 (1.8%) died; parenteral antimicrobials were given in 59 patients (9.5%) preceded by bacteriological tests in 48 (81.4%). Comparing before and during the pandemic, parametric analyses showed that the means of total AUD decreased from 16.767 (PreY) to 15.62 (Pan1Y+Pan2Y) (P=0.034). Likewise, the means of carbapenems’ AUD showed decrease from 0.773 (PreY) to 0.462 (Pan1Y) but increase into 0.777 (Pan2Y) (P=0.001).The non-parametric comparison between COVID-19 and other wards showed that the medians of AUD in the COVID-19 wards were significantly (PConclusion: The COVID-19 pandemic stewardship decreased the total AUD and may have contributed to decrease ESBL-producing microbes and C. difficile infection. The burden of sepsis-3 may have fluctuated the carbapenems’ use.

Background Sotrovimab has been developed to neutralize SARS-CoV-2 which remained effective at the advent of B.1 lineage of the Omicron variant. To investigate post-infusion clinical events and their risk factors, we performed a retrospective study.Methods Subjects were a consecutive series of inpatients with COVID-19 undergoing an infusion of sotrovimab in our institute. In accordance with previous clinical trials, we included patients at risk but permitted SARS-CoV-2 vaccinees. For statistical analyses, we reviewed background factors of demographics, imaging, and laboratory findings for the outcome of post-infusion events such as temperature over 38 degrees Celsius (Temp38) and pulse oximetry below 94%.Results Of a total of 136 patients, the median follow-up was 47 days. Among 110 fully vaccinated patients (80.9%) for SARS-CoV-2, 2-time vaccinees accounted for 88 while 3-time vaccinees were 22. Three patients (2.2%) showed worsening of COVID-19; one developed hypoxia and two died. For the outcome of Temp38 (N=41), multivariate analysis showed that factors at risk were younger age (2) (OR 8.657, 95% CI 1.030 – 72.786, P=0.047) and pulse oximetry (