Agomelatine has significantly higher efficacy and potential acceptability compared to SSRIs and SNRIs when treating MDD. However, the difference in efficacy is not considered clinically relevant. Because of its unique chronobiotic effects, agomelatine may be useful for the management of some MDD patients with circadian disturbance.

A rapid increase of nosocomial vancomycin-resistant enterococci (VRE) from 23.3% in 2009 to 44.5% in 2018 among all the medical centers in Taiwan was found. The aim of the study was to explore the relationship between antimicrobial usage and prevalence of VRE. We conducted the study between January 2010 and December 2019 in a tertiary teaching hospital in Taiwan. Antibiotic consumption was expressed as defined daily doses (DDDs) per 1,000 patient-days (PDs). The trend in antibiotic consumption and VRE prevalence were analyzed by regression analysis with yearly data. Pearson's correlation analysis was used to determine the relationship between antibiotic consumption and the prevalence of VRE. The total consumption of antibiotics increased significantly from 450.6 DDDs/1,000 PDs in 2010 to 520.1 DDDs/1,000 PDs in 2019 (P = 0.013). Positive correlations were found between the prevalence of vancomycinresistant Enterococcus faecium and the consumption of amoxicillin/clavulanate, vancomycin, and carbapenems, which included meropenem (P < 0.05). The increase in total VRE prevalence was significantly correlated with increased consumption of vancomycin and carbapenems, which included meropenem (P < 0.05). This 10-year study in a hospital demonstrated changes in antimicrobial use, which may have affected VRE prevalence in the hospital. We found a rise in nosocomial VRE prevalence was associated with the use of specific antimicrobial agents.

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Background and aims:Use of anti-TNF agents increases the risk of TB, especially in Asian countries. The guideline suggested that the treatment of latent TB infection (LTBI) is recommended with oral isoniazid (INH) nine months and used TNF-α antagonist four weeks after treatment. However, the TB infection prevention by using TNF-α antagonist remains unclear in Taiwan. We evaluated the adherence rates of patients received anti -TNF agents with latent tuberculosis infection (LTBI) prophylaxis treatment.Methods:Retrospectively collected the medical records of outpatient received adalimumab from Jan. 2014 to Dec. 2015. Brio Query version 6 as a computer program to collect patient informationResults:There are 49 patients included in this study. Eighteen percent (9/49) of the patients received LTBI prophylaxis. Seventy eight percent (7/9) patients were found of positive QuantiFERON test, and 22% (2/9) revealed intermediate results. One of the patient with Anti-HBc (+) and HCV (+) ceased treatment four months later. He was found of ALT level increase to 98 IU/L while taking INH again in the first month. The liver function returned to normal after INH discontinuation. The other 89% (8/9) completed 9 months treatment course. One of them is hepatitis B carrier with liver function impairment after taking medicine for six months. This individual case was done in closely monitored by doctor, and hepatic function return to normal three months after treatment.Conclusion:This study shows the risk of INH-induced liver function impairment is higher than the other country. The QuantiFERON testing are highly recommend if patients taking TNF-α inhibitor and another therapy instead seems to be more in line with prophylaxis for tuberculosis in Taiwan.