Risk of gastrointestinal perforation in patients taking oral fluoroquinolone therapy: An analysis of nationally representative cohort
| Autor: | Szu-Ta Chen, Meng Tse Gabriel Lee, Yi-Wen Tsai, Lorenzo Porta, Si Huei Lee, Shou Chien Hsu, Yi Chieh Weng, Shy Shin Chang, Shen Che Lin, Chien-Chang Lee, Jiunn Yih Wu |
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| Přispěvatelé: | Hsu, S, Chang, S, Lee, M, Lee, S, Tsai, Y, Lin, S, Chen, S, Weng, Y, Porta, L, Wu, J, Lee, C |
| Rok vydání: | 2017 |
| Předmět: |
Male
Pediatrics Gastrointestinal Diseases NSAIDs lcsh:Medicine Administration Oral Biochemistry Cohort Studies Tendons 0302 clinical medicine Fluoroquinolone Risk Factors Medicine and Health Sciences Medicine Gastrointestinal Infections 030212 general & internal medicine lcsh:Science Gastrointestinal tract Analgesics Multidisciplinary Drugs Gastrointestinal Analysis Middle Aged Intestine Anti-Bacterial Agents Intestines Treatment Outcome Bioassays and Physiological Analysis Connective Tissue Cohort Comparators Regression Analysis Engineering and Technology 030211 gastroenterology & hepatology Female Anatomy Case-Control Studie Risk assessment Human Cohort study Fluoroquinolones Research Article medicine.medical_specialty Gastrointestinal Disease Perforation (oil well) Taiwan Surgical and Invasive Medical Procedures Gastroenterology and Hepatology Research and Analysis Methods Risk Assessment Sensitivity and Specificity Regression Analysi Enteritis 03 medical and health sciences Digestive System Procedures Gastrointestinal perforation Anti-Bacterial Agent Humans Aged Pharmacology business.industry Risk Factor lcsh:R Case-control study Biology and Life Sciences Proteins medicine.disease Pain management Gastrointestinal Tract Biological Tissue Intestinal Perforation Case-Control Studies lcsh:Q Cohort Studie Electronics business Digestive System Collagens |
| Zdroj: | PLoS ONE PLoS ONE, Vol 12, Iss 9, p e0183813 (2017) |
| ISSN: | 1932-6203 |
| Popis: | Background: Fluoroquinolone is a commonly prescribed antimicrobial agent, and up to 20% of its users registers adverse gastroenterological symptoms. We aimed to evaluate the association between use of fluoroquinolone and gastrointestinal tract perforation. Methods: We conducted a nested case-control study on a national health insurance claims database between 1998 and 2011. The use of fluoroquinolones was classified into current (< 60 days), past (61–365 days prior to the index date) and any prior year use of fluoroquinolones. We used the conditional logistic regression model to estimate rate ratios (RRs), adjusting or matching by a disease risk score (DRS). Results: We identified a cohort of 17,510 individuals diagnosed with gastrointestinal perforation and matched them to 1,751,000 controls. Current use of fluoroquinolone was associated with the greatest increase in risk of gastrointestinal perforations after DRS score adjustment (RR, 1.90; 95% CI, 1.62–2.22). The risk of gastrointestinal perforation was attenuated for past (RR, 1.33; 95% CI, 1.20–1.47) and any prior year use (RR, 1.46; 95% CI, 1.34–1.59). To gain insights into whether the observed association can be explained by unmeasured confounder, we compared the risk of gastrointestinal perforation between fluoroquinolone and macrolide. Use of macrolide, an active comparator, was not associated with a significant increased risk of gastrointestinal perforation (RR, 1.11, 95%CI, 0.15–7.99). Sensitivity analysis focusing on perforation requiring in-hospital procedures also demonstrated an increased risk associated with current use. To mitigate selection bias, we have also excluded people who have never used fluoroquinolone before or people with infectious colitis, enteritis or gastroenteritis. In both of the analysis, a higher risk of gastrointestinal perforation was still associated with the use of fluoroquinolone. Conclusions: We found that use of fluoroquinolones was associated with a non-negligible increased risk of gastrointestinal perforation, and physicians should be aware of this possible association |
| Databáze: | OpenAIRE |
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