Li Yanwei, Chen Li, Tang Xiting, Luo Lan, Wang Chengliang
Department of Pharmacy, People's Hospital of Ganzi Tibetan Autonomous Prefecture, Kangding, Sichuan, China.
Department of Pharmacology, Faculty of Medicine, UPV/EHU, Leioa, Spain.
Expert Opin Drug Saf. 2024 Sep 19:1-13. doi: 10.1080/14740338.2024.2392862.
This study investigates adverse drug event (ADE) reports from the FAERS related to FQs drugs in patients aged 65 and older. The findings aim to guide the rational clinical use of these drugs in elderly patients.
We employed Reporting Odds Ratio (ROR) and Proportional Reporting Ratio (PRR) methods to analyze ADE reports for the representative FQ drugs from Q1 2015 to Q4 2023, covering 36 quarters.
The analysis identified 6883 ADE cases for ciprofloxacin, 5866 for levofloxacin, 1498 for moxifloxacin, and 317 for ofloxacin. Moxifloxacin showed higher incidences of Cardiac disorders and Psychiatric disorders ADEs (4.01%, 23.11%). Ciprofloxacin and levofloxacin showed higher ADE rates in musculoskeletal and connective tissue diseases (20.18% and 26.97%) compared to moxifloxacin (3.62%) and ofloxacin (9.25%). Additionally, moxifloxacin and ofloxacin showed higher ADE rates for eye disorders (10.61% and 15.03%).
Different FQs exhibit varying ADE profiles across cardiovascular, vascular and lymphatic, renal and urinary, psychiatric, musculoskeletal and connective tissue, and ocular systems. Patients with underlying systemic diseases should avoid FQs with higher ADE risks for their conditions. Personalized medication plans for elderly patients should also be strengthened.
本研究调查了美国食品药品监督管理局不良事件报告系统（FAERS）中与氟喹诺酮类（FQ）药物相关的65岁及以上患者的药物不良事件（ADE）报告。研究结果旨在指导这些药物在老年患者中的合理临床应用。
我们采用报告比值比（ROR）和比例报告比值（PRR）方法，分析了2015年第一季度至2023年第四季度共36个季度中代表性FQ药物的ADE报告。
分析确定环丙沙星的ADE病例有6883例，左氧氟沙星有5866例，莫西沙星有1498例，氧氟沙星有317例。莫西沙星的心脏疾病和精神疾病ADE发生率较高（分别为4.01%和23.11%）。与莫西沙星（3.62%）和氧氟沙星（9.25%）相比，环丙沙星和左氧氟沙星在肌肉骨骼和结缔组织疾病中的ADE发生率更高（分别为20.18%和26.97%）。此外，莫西沙星和氧氟沙星的眼部疾病ADE发生率更高（分别为10.61%和15.03%）。
不同的FQ在心血管、血管和淋巴、肾脏和泌尿系统、精神、肌肉骨骼和结缔组织以及眼部系统中表现出不同的ADE特征。患有潜在全身性疾病的患者应避免使用对其病情有较高ADE风险的FQ。还应加强老年患者的个性化用药方案。
