Fleming Virginia H, Xu Jianing, Chen Xianyan, Hall Daniel, Southwood Robin L
College of Pharmacy, University of Georgia, Athens, GA, USA.
Department of Statistics, University of Georgia, Athens, GA, USA.
J Pharm Technol. 2024 Dec 22:87551225241303848. doi: 10.1177/87551225241303848.
Fluoroquinolones (FQs) are associated with potential tendon injury but comparative risk versus other antibiotic (non-FQ) options for the same indication has rarely been evaluated.
Describe the incidence (relative risk) of any tendon injury in patients receiving FQs compared with other (non-FQ) antibiotics for treatment of urinary tract infections (UTIs).
A retrospective propensity score-weighted cohort study was performed to evaluate the association between FQ antibiotics and tendon injury at two time points (within one month and within six months of use) compared with non-FQ regimens for treatment of UTI. The evaluation was performed using the Merative™ MarketScan Research Databases from 2014 to 2020. Adult patients with International Classification of Diseases (ICD)-9/10 coding for UTI were included. Patients with a history of tendon injury or those who received both FQ and non-FQ regimens during the study period were excluded. Propensity score weighting was used to adjust for selection bias due to contributing risk factors, including demographics (age, sex), comorbidities (diabetes mellitus, chronic kidney disease), and concurrent medications (corticosteroids).
Both the 1-month and 6-month cohorts were predominately female and less than 50 years of age. At one month, the incidence of tendon injury was 0.2% in the FQ group and 0.1% in the non-FQ group, and the odds of tendon injury were not estimated to be significantly different between groups (odds ratio [OR] = 1.03, 95% confidence interval [CI] 0.93, 1.32). Odds of tendon injury were also not estimated to be significantly different in the 6-month cohort (OR = 0.98, 95% CI 0.84, 1.05).
In this population of predominantly young female patients without high incidence of potentially contributing comorbidities, increased risk of tendon injury was not associated with FQ use. Future research is needed to determine whether demographic differences between this and other previously studied populations account for this discordant result.
氟喹诺酮类药物（FQs）与潜在的肌腱损伤有关，但对于相同适应症，其与其他抗生素（非氟喹诺酮类）相比的相对风险很少被评估。
描述接受氟喹诺酮类药物治疗的患者与接受其他（非氟喹诺酮类）抗生素治疗尿路感染（UTIs）的患者相比发生任何肌腱损伤的发生率（相对风险）。
进行了一项回顾性倾向评分加权队列研究，以评估氟喹诺酮类抗生素与肌腱损伤在两个时间点（使用后1个月内和6个月内）之间的关联，并与用于治疗尿路感染的非氟喹诺酮类治疗方案进行比较。使用2014年至2020年的默克多™市场扫描研究数据库进行评估。纳入具有国际疾病分类（ICD）-9/10编码的尿路感染成年患者。排除有肌腱损伤史或在研究期间同时接受氟喹诺酮类和非氟喹诺酮类治疗方案的患者。倾向评分加权用于调整由于包括人口统计学特征（年龄、性别）、合并症（糖尿病、慢性肾病）和同时使用的药物（皮质类固醇）在内的促成风险因素导致的选择偏倚。
1个月和6个月队列中的患者主要为女性且年龄小于50岁。在1个月时，氟喹诺酮类药物组肌腱损伤发生率为0.2%，非氟喹诺酮类药物组为0.1%，两组之间肌腱损伤几率估计无显著差异（优势比[OR]=1.03，95%置信区间[CI]0.9, 1.32）。6个月队列中肌腱损伤几率估计也无显著差异（OR = 0.98，95% CI 0.84, 1.05）。
在这个主要为年轻女性患者且潜在促成合并症发生率不高的人群中，肌腱损伤风险增加与使用氟喹诺酮类药物无关。需要进一步研究以确定该人群与其他先前研究人群之间的人口统计学差异是否导致了这一不一致的结果。
