Fluoroquinolones were associated with higher risk for gastrointestinal (GI) perforation in this large, population-based study.
Why this matters
- Fluoroquinolone use is on the rise.
- The drugs may adversely affect collagen, which is abundant in the GI system.
- Current FDA fluoroquinolone warnings concern non-GI systems.
- Fluoroquinolone use was associated with higher GI perforation risk vs nonuse.
- Current use rate ratios (RRs; all P<.001 unadjusted risk: adjusted for disease risk score rs-matched:>
- Past-use RRs (all P<.001 unadjusted risk: drs-matched:>
- Prior-year RRs (all P<.001 unadjusted risk: drs-matched:>
- Fluoroquinolone associated with higher GI perforation risk vs macrolide (RR, 1.90 [P<.001 vs>
- Unadjusted, DRS-adjusted RRs rose with longer duration of use.
- Longitudinal, nested case-control, population-based study of 1 million randomly chosen adults, Taiwan National Health Insurance Research Database.
- Participants followed from January 1998 to December 2011.
- 100 control participants (n=1,751,000) assigned for each perforation event (n=17,510), stratified by date, age, and sex.
- Adjusted for multiple relevant covariates.
- Endpoint: GI perforation.
- Funding: Taiwan National Ministry of Science and Technology.
- Drug adherence and confounders (eg, smoking, drinking) not assessed.
- Causal relationship cannot be established from this study design.