McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, Room 216, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada.
School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Eur J Clin Pharmacol. 2022 Jun;78(6):1019-1028. doi: 10.1007/s00228-021-03260-4. Epub 2022 Mar 15.
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).
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.
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).
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.
喹诺酮类是一种广受欢迎的抗生素,以其效力、广泛的覆盖范围和合理的安全性而闻名。人们对喹诺酮类药物与视网膜脱离(RD)之间可能存在的关联表示担忧。
我们使用 Health Facts® 数据库中的电子健康记录(EHR)进行了一项巢式病例对照研究。初始队列包括 2000 年至 2016 年期间住院、无眼部疾病史且至少有一年医疗史的所有患者。合格病例包括 2010 年至 2015 年期间首次以 RD 为主要诊断入院的住院患者。每个合格病例通过性别、种族、年龄和风险期与五个独特的对照无替换匹配。我们使用条件逻辑回归计算 RD 风险,调整了其他药物暴露和主要危险因素。
我们确定了 772 例病例和 3860 例对照。虽然我们对所有受试者的主要分析并未发现喹诺酮类药物与 RD 风险相关,但在非裔美国人(环丙沙星和左氧氟沙星)、56-70 岁年龄组(莫西沙星)和女性(环丙沙星)中观察到风险升高但无统计学意义。
我们的研究未发现全身使用喹诺酮类抗生素后 30 天内 RD 风险升高。在一些人群亚组中观察到的风险增加的建议需要进一步调查。