Kidney Injury Following Ibuprofen and Acetaminophen: A Real-World Analysis of Post-Marketing Surveillance Data.

Background: Although kidney injury has been reported as a serious adverse effect in patients treated with ibuprofen or acetaminophen (APAP), there are still few real-world studies to compare the specific differences in the adverse effects of nephrotoxicity. Methods: Disproportionality analysis and Bayesian analysis were devoted to data-mining of the suspected kidney injury after using ibuprofen and APAP based on the FDA's Adverse Event Reporting System (FAERS) from January 2004 to March 2021. The times to onset, fatality, and hospitalization rates of ibuprofen-associated kidney injury and APAP-associated kidney injury were also investigated. Results: 2,453 reports of ibuprofen-associated kidney injury and 1,288 reports of APAP-associated kidney injury were identified. Ibuprofen appeared to affected more middle-aged patients than elderly ones (27.76 vs 16.53%) while APAP appeared to affected more young patients than middle-aged patients (45.24 vs 29.10%) and elderly patients were fewer (13.99%). Compared to ibuprofen, APAP had the higher association with renal injury based on the higher reporting odds ratio (ROR = 2.45, 95% two-sided CI = 2.36-2.56), proportional reporting ratio (PRR = 2.39, χ 2 = 2002.94) and empirical Bayes geometric mean (EBGM = 2.38, 95% one-sided CI = 2.3). In addition, APAP-associated kidney injury had earlier onset (32.74 vs 115.82 days, p < 0.0001) and a higher fatality rate (44.43 vs 7.36%, p < 0.001) than those of ibuprofen-associated kidney injury. Conclusion: The analysis of FAERS data provides a more accurate profile on the incidence and prognosis of kidney injury after ibuprofen and acetaminophen treatment, enabling continued surveillance and timely intervention in patients at risk of kidney injury using these drugs.

Population Pharmacokinetics of Vancomycin in Chinese ICU Neonates: Initial Dosage Recommendations.

The main goal of our study was to characterize the population pharmacokinetics of vancomycin in critically ill Chinese neonates to develop a pharmacokinetic model and investigate factors that have significant influences on the pharmacokinetics of vancomycin in this population. The study population consisted of 80 neonates in the neonatal intensive care unit (ICU) from which 165 trough and peak concentrations of vancomycin were obtained. Nonlinear mixed effect modeling was used to develop a population pharmacokinetic model for vancomycin. The stability and predictive ability of the final model were evaluated based on diagnostic plots, normalized prediction distribution errors and the bootstrap method. Serum creatinine (Scr) and body weight were significant covariates on the clearance of vancomycin. The average clearance was 0.309 L/h for a neonate with Scr of 23.3 µmol/L and body weight of 2.9 kg. No obvious ethnic differences in the clearance of vancomycin were found relative to the earlier studies of Caucasian neonates. Moreover, the established model indicated that in patients with a greater renal clearance status, especially Scr < 15 µmol/L, current guideline recommendations would likely not achieve therapeutic area under the concentration-time curve over 24 h/minimum inhibitory concentration (AUC24h/MIC) ≥ 400. The exceptions to this are British National Formulary (2016-2017), Blue Book (2016) and Neofax (2017). Recommended dose regimens for neonates with different Scr levels and postmenstrual ages were estimated based on Monte Carlo simulations and the established model. These findings will be valuable for developing individualized dosage regimens in the neonatal ICU setting.

Synthesis and Structural Characterization of an Unusual Oxygen-Linked Double Cubane-Like Cluster {[Mo(3)PbOS(3)](OAc)(2)(py)(3)(dtp)(2)O}(2).

The unusual oxygen-linked double cubane-like cluster compound {[Mo(3)PbOS(3)](OAc)(2)(py)(3)(dtp)(2)O}(2) (A) (dtp = S(2)P(OEt(2))(-), OAc = CH(3)COO(-), py = C(5)H(5)N) was obtained for the first time by the reaction of the mixed S/O-bridged cluster [Mo(3)(&mgr;(3)-O)(&mgr;-S)(3)(dtp)(4)H(2)O] (B) with Pb(OAc)(2).3H(2)O in the presence of excess CH(3)COOH and pyridine. It has been characterized by IR, Raman, UV-vis, and X-ray structure analysis. The molecule contains a crystallographic center of inversion and can be viewed as consisting of two [Mo(3)PbOS(3)](6+) cubane-like cores linked through a pair of oxygen bridges with Mo-(&mgr;-O) bond lengths of ca. 1.89 Å. The cell dimensions are a = 11.705(8) Å, b = 19.527(8) Å, c = 20.670(9) Å, beta = 98.14(4) degrees, V = 4677(8) Å(3), Z = 2 in the space group P2(1)/n. The final R = 0.056, R(w) = 0.068 for 5424 reflections with I >/= 3sigma(I). The average Mo-Mo bond distance is 2.613(1) Å and the nonbonding Mo-Pb distances lie in the range from 3.997(1) to 4.090(1) Å. The spectra of IR, Raman, and UV-vis spectra are also shown in this paper.