Systemic quinolones and risk of acute liver failure III: A nested case-control study using a US electronic health records database.

Anti-Bacterial Agents / adverse effects Case-Control Studies Databases, Factual Electronic Health Records Female Humans Liver Failure, Acute / chemically induced Male Quinolones
acute liver failure drug safety electronic health record nested case-control pharmacovigilance quinolones

Journal

Journal of gastroenterology and hepatology
ISSN: 1440-1746
Titre abrégé: J Gastroenterol Hepatol
Pays: Australia
ID NLM: 8607909

Informations de publication

Date de publication:
Aug 2021
Historique:
revised: 19 02 2021
received: 06 01 2021
accepted: 14 03 2021
pubmed: 24 3 2021
medline: 10 2 2022
entrez: 23 3 2021
Statut: ppublish

Résumé

Quinolones are globally popular antibiotics with proven potency, broad coverage, and reasonable safety. However, some concerns were raised as to their possible association with acute liver failure (ALF). The aim of this study is to assess ALF risk within 30 days of receiving a systemically administered quinolone antibiotic, in individuals with no history of liver/diseases. We conducted a nested case-control study using electronic health records from the Cerner Health Facts. The initial cohort (n = 35 349 943) included all patients who were admitted between 2000 and 2016, with no history of liver diseases, and had a minimum medical history of one year. Eligible cases were inpatients who were first diagnosed with ALF between 2010 and 2015. Using incidence density sampling, each case was matched with up to five unique controls by sex, race, age at index encounter, and period-at-risk. We used conditional logistic regression to calculate the odds ratio and 95% confidence interval for ALF risk, upon adjusting for exposure to other medications, and major confounders (diabetes mellitus and alcohol abuse). We used the STROBE Statement for reporting on our study. We identified 3151 cases and 15 657 controls. Our primary analysis did not reveal an association between quinolones and ALF risk. However, some risk was identified among those with no or few comorbidities, those ≤ 60 years of age, women, men, African Americans, and Caucasians. Although our study does not suggest an overall association between quinolones and ALF, elevated risks seen in some subgroups warrant further investigation.

Sections du résumé

BACKGROUND AND AIM OBJECTIVE
Quinolones are globally popular antibiotics with proven potency, broad coverage, and reasonable safety. However, some concerns were raised as to their possible association with acute liver failure (ALF). The aim of this study is to assess ALF risk within 30 days of receiving a systemically administered quinolone antibiotic, in individuals with no history of liver/diseases.
METHODS METHODS
We conducted a nested case-control study using electronic health records from the Cerner Health Facts. The initial cohort (n = 35 349 943) included all patients who were admitted between 2000 and 2016, with no history of liver diseases, and had a minimum medical history of one year. Eligible cases were inpatients who were first diagnosed with ALF between 2010 and 2015. Using incidence density sampling, each case was matched with up to five unique controls by sex, race, age at index encounter, and period-at-risk. We used conditional logistic regression to calculate the odds ratio and 95% confidence interval for ALF risk, upon adjusting for exposure to other medications, and major confounders (diabetes mellitus and alcohol abuse). We used the STROBE Statement for reporting on our study.
RESULTS RESULTS
We identified 3151 cases and 15 657 controls. Our primary analysis did not reveal an association between quinolones and ALF risk. However, some risk was identified among those with no or few comorbidities, those ≤ 60 years of age, women, men, African Americans, and Caucasians.
CONCLUSION CONCLUSIONS
Although our study does not suggest an overall association between quinolones and ALF, elevated risks seen in some subgroups warrant further investigation.

Identifiants

DOI: 10.1111/jgh.15504 PMID: 33755266 PMC: PMC8451826
pubmed: 33755266
doi: 10.1111/jgh.15504
pmc: PMC8451826
doi:

Substances chimiques

Anti-Bacterial Agents 0
Quinolones 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2307-2314

Subventions

Organisme : McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa

Informations de copyright

© 2021 The Authors. Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

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Auteurs

Mohamed Kadry Taher (MK)

McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
Risk Sciences International, Ottawa, Ontario, Canada.
ORCID: 0000-0002-5754-7512

James A G Crispo (JAG)

McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Human Sciences Division, Northern Ontario School of Medicine, Sudbury, Ontario, Canada.

Yannick Fortin (Y)

McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Statistics Canada, Ottawa, Ontario, Canada.

Ryan Moog (R)

Cerner Corporation, Kansas City, Missouri, USA.

Douglas McNair (D)

Bill & Melinda Gates Foundation, Seattle, Washington, USA.
ORCID: 0000-0003-0965-883X

Lise M Bjerre (LM)

School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Institut du Savoir Montfort, Ottawa, Ontario, Canada.

Franco Momoli (F)

School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
Risk Sciences International, Ottawa, Ontario, Canada.
Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.

Donald Mattison (D)

McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
Risk Sciences International, Ottawa, Ontario, Canada.

Daniel Krewski (D)

McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
Risk Sciences International, Ottawa, Ontario, Canada.

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questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Anti-infectieux › Antibactériens › Systemic quinolones and risk of acute liver...
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questionsmedicales.fr › Composés hétérocycliques › Composés hétérocycliques à cycles fusionnés › Composés hétérobicycliques › Quinoléines › Quinolinone › Systemic quinolones and risk of acute liver...