The following is a summary of “Association Between Fluoroquinolone Use and Hospitalization With Aortic Aneurysm or Aortic Dissection,” published in the August 2023 issue of Cardiology by Brown et al.
For a study, researchers aimed to investigate the link between fluoroquinolone usage and aortic aneurysm or dissection by utilizing various study designs and multiple databases. They analyzed 2 separate studies, a cohort, and a case crossover, and assessed fluoroquinolone use and aortic hospitalization via hazard and odds ratios, respectively.
In the cohort study, researchers found 3,134,121 adults in Aurum (mean age 52.5 [SD 20.3] years; 1,969,257 [62.8%] female) and 452,086 in GOLD (mean age 53.9 [SD 20.2] years; 286,502 [63.4%] female) who were prescribed fluoroquinolones or cephalosporins. Initially, there was an evident association between fluoroquinolone use and higher hospitalization rates due to aortic aneurysm or dissection (pooled HR 1.28; 95% CI 1.13-1.44; P < .001). However, this association disappeared after adjusting for potential influencing factors (pooled adjusted HR 1.03; 95% CI 0.91-1.17; P = .65).
In the case-crossover study, 84,841 individuals in Aurum (mean age 75.5 [SD 10.9] years; 23,551 [27.8%] female) and 10,357 in GOLD (mean age 75.6 [SD 10.5] years; 2,809 [27.1%] female) were hospitalized due to aortic aneurysm or dissection. Comparatively, fluoroquinolone use was linked to increased hospitalization for these conditions compared to nonuse. However, no significant association was found compared to other antibiotics (vs cephalosporin pooled OR, 1.05; 95% CI, 0.87-1.27; vs trimethoprim, 0.89; 95% CI, 0.75-1.06; vs co-amoxiclav, 0.98; 95% CI, 0.82-1.18).
The findings indicate that other factors might influence the connection between fluoroquinolones and aortic aneurysm or dissection. However, no clear association was observed once these influencing factors were considered. This offers reassurance regarding the safety of fluoroquinolones concerning the risk of aortic aneurysm or dissection.
Source: jamanetwork.com/journals/jamacardiology/article-abstract/2808412
