Fluoroquinolones and prolonged GI perforation risk

  • PLoS One

  • Jenny Blair, MD
  • Clinical Essentials
L'accesso ai contenuti di questo sito è riservato agli operatori del settore sanitario italiano L'accesso ai contenuti di questo sito è riservato agli operatori del settore sanitario italiano

Takeaway

  • 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.

Key results

  • 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.

Study design

  • 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.

Limitations

  • Drug adherence and confounders (eg, smoking, drinking) not assessed.
  • Causal relationship cannot be established from this study design.