Aortic & peripheral vascular diseaseCohort study
Association Between Fluoroquinolone Use and Hospitalization With Aortic Aneurysm or Aortic Dissection
- Cohort and case-crossover studies
- 2 UK primary care databases (CPRD Aurum and GOLD)
- stabilized inverse probability of treatment weighting
- case-crossover controls matched 1:3
- fixed-effects meta-analysis across databases
Authors' conclusion
The results in this study suggest that estimates of association of fluoroquinolones with aortic aneurysm or dissection may be affected by confounding. When such confounding is accounted for, no association was evident, providing reassurance on the safety of fluoroquinolones with respect to aortic aneurysm or dissection.
Study context
- Population
- Adults prescribed systemic fluoroquinolones or cephalosporins (cohort) or hospitalized with aortic aneurysm or dissection (case-crossover), UK primary care, April 1997–December 2019cohort: Aurum 3,134,121, GOLD 452,086
- Exposure
- Fluoroquinolone vs cephalosporin (cohort); fluoroquinolone vs nonuse and other antibiotics (case-crossover)
- Outcome
- Hospitalization with aortic aneurysm or dissection
Main finding
As reported in the abstract
Hospitalization with aortic aneurysm or dissection (cohort)
Fluoroquinolone vs CephalosporinEstimate (95% CI)P value
crude
pooled HR 1.28(1.13–1.44)
P < 0.001adjusted for potential confounders
pooled adjusted HR 1.03(0.91–1.17)
P = 0.65Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| Hospitalization with aortic aneurysm or dissection (case-crossover; Aurum 84 841, GOLD 10 357 cases) — Fluoroquinolone vs Cephalosporin | pooled OR 1.05 (95% CI 0.87–1.27) | |
| Hospitalization with aortic aneurysm or dissection (case-crossover; Aurum 84 841, GOLD 10 357 cases) — Fluoroquinolone vs Trimethoprim | OR 0.89 (95% CI 0.75–1.06) | |
| Hospitalization with aortic aneurysm or dissection (case-crossover; Aurum 84 841, GOLD 10 357 cases) — Fluoroquinolone vs Co-amoxiclav | OR 0.98 (95% CI 0.82–1.18) | |
| 0.512Ratio (log scale) |
Hospitalization with aortic aneurysm or dissection (case-crossover; Aurum 84 841, GOLD 10 357 cases)
- Relative to nonuse, fluoroquinolone use associated with increased hospitalization
Original publication
Association Between Fluoroquinolone Use and Hospitalization With Aortic Aneurysm or Aortic Dissection. JAMA Cardiol. Published 1 September 2023. doi:10.1001/jamacardio.2023.2418
Summarised from the published abstract; every number is checked against it