Systemic quinolones and risk of retinal detachment III: a nested case–control study using a US electronic health records database

Abstract

Background Quinolones are popular antibiotics that are known for their potency, broad coverage, and reasonable safety. Concerns have been raised about a possible association between quinolones and retinal detachment (RD). Methods We conducted a nested case–control study using electronic health records (EHR) from the Health Facts® Database. The initial cohort included all patients who were admitted between 2000 and 2016, with no history of eye disease, and had a minimum medical history of one year. Eligible cases comprised inpatients who were first admitted with a primary diagnosis of RD between 2010 and 2015. Each eligible case was matched without replacement to five unique controls by sex, race, age, and period-at-risk. We used conditional logistic regression to calculate RD risk, adjusting for exposure to other medications, and major risk factors. Results We identified 772 cases and 3860 controls. Whereas our primary analysis of all subjects revealed no quinolone-associated RD risk, elevated but non-significant risks were noted in African Americans (ciprofloxacin and levofloxacin), those aged 56–70 years old (moxifloxacin), and women (ciprofloxacin). Conclusion Our study did not identify an elevated RD risk within 30 days following systemic administration of quinolone antibiotics. Suggestions of increased risk observed in some population subgroups warrant further investigation.

Overview of Tendinopathy, Peripheral Neuropathy, Aortic Aneurysm, and Hypoglycemia Caused by Fluoroquinolones

“…Moreover, a study examining the adverse drug event reports submitted to FAERS found a positive association of Moxifloxacin with RRD. 53 Conversely, other studies including a nationwide, registerbased cohort study from Denmark, 54 two case-control analyses from USA, 55,56 a retrospective cohort study using The Health Improvement Network database, 57 a self-controlled case series study of data from Hong Kong Clinical Data Analysis and Reporting System Database and Taiwan National Health Insurance Research Database, 58 a nested casecontrol study of Korean National Health Insurance Service National Sample Cohort data, 59 and a nested case-control study of electronic health records 60 found no association between oral FQ use and retinal detachment. In addition, few systematic reviews and meta-analyses [61][62][63] did not also find any association of development of RRD with the use of systemic FQs.…”

Overview of Side-Effects of Antibacterial Fluoroquinolones: New Drugs versus Old Drugs, a Step Forward in the Safety Profile?

“…Of the targeted FQs, only moxifloxacin showed a positive disproportionality signal for retinal detachment. However, Taher et al [ 222 ] found no increased risk of retinal detachment within 30 days following FQs systemic administration.…”

“…Women were shown to be more at risk than men, while African Americans were found to be more at risk than Caucasians. There was also a five-fold risk in the youngest-age tertile (0–55), which decreased and became non-significant in the higher-age tertiles [ 222 ].…”

Safety of fluoroquinolones

“…Many large cohort studies have showed conflicting results concerning the association between retinal detachment and FQs use. Further studies with additional information disclose the necessity of complementary studies to clarify these data [ 49 , 50 ].…”

“…Muchos estudios de cohortes de gran envergadura han mostrado resultados contradictorios en cuanto a la asociación entre el desprendimiento de retina y el uso de FQs. Parece necesario realizar más estudios con información adicional para complementar estos datos [49,50].…”