An 80-year-old woman underwent pancreatoduodenectomy. Post-operation, she experienced a fever, and a culture of blood revealed metallo-beta-lactamase-producing Raoultella ornithinolytica. For treatments with aminoglycoside antimicrobial agents, a therapeutic drug monitoring-based dosing design can lower the risk of adverse events and enable appropriate treatment. Key Clinical Message. When aminoglycoside antimicrobial agents are administered for MBL-producing bacteremia, prescription suggestions based on TDM by antimicrobial stewardship team can reduce the occurrence of adverse events and enable appropriate treatment.

To improve the COVID-19 vaccination rate, it is necessary for medical professionals to provide appropriate information about the vaccination to the public. In the present study, to clarify the relationship between pharmacist opinions about providing information on COVID-19 vaccination, and the occurrence of adverse reactions with the vaccination, questionnaire surveys for pharmacists vaccinated against COVID-19 were performed. Pharmacist opinions were analyzed by Berelsonʼs content analysis. A total of 216 valid questionnaires were collected. The number of pharmacists that had trepidation about the vaccination was 59.0％ (1st dose) and 60.6％ (2nd dose), respectively, and the safety of the vaccine was the most common reason for the response. Pain at the injection site was the most common adverse reaction with the vaccination. The incidence of headache, chills, fever, and joint pain increased on the 2nd dose compared to the 1st. The most common pharmacist opinion was about adverse reactions of the vaccine. These results suggest that pharmacists, as medical professionals felt apprehensive through the experience of adverse reactions, or gathering information about the vaccine. We could clarify the pharmacist opinion that it is important to provide information about adverse reactions for promoting the COVID-19 vaccination. Thus, we hope that pharmacists can dispel general public anxiety over the COVID-19 vaccination by providing accurate information of adverse reactions, such as those that are likely to occur in each dose, the timing of their occurrence, how to deal with adverse reactions, and that this then leads to promoting the publicʼs uptake of the COVID-19 vaccination.

A 56-year-old woman with a history of connective tissue disease developed fever, and Bacillus cereus (B. cereus) was detected in blood cultures. Therefore, treatment with vancomycin (VCM) was initiated. Since her blood cultures persistently detected B. cereus despite peripheral intravenous catheter replacement and VCM treatment, concomitant treatment with gentamicin (GM) was started. Blood cultures then became negative. Persistent B. cereus bacteremia responded to combination therapy with VCM and GM. This combination therapy may increase the risk of developing renal dysfunction, but the risk can be mitigated by appropriate therapeutic drug monitoring (TDM) and dose adjustments to achieve successful treatment.