Increased Incidence of Pseudotumor Cerebri Syndrome Among Users of Tetracycline Antibiotics.
Journal
Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society
ISSN: 1536-5166
Titre abrégé: J Neuroophthalmol
Pays: United States
ID NLM: 9431308
Informations de publication
Date de publication:
01 09 2022
01 09 2022
Historique:
pubmed:
16
4
2022
medline:
30
9
2022
entrez:
15
4
2022
Statut:
ppublish
Résumé
To determine whether the use of a tetracycline-class antibiotic is associated with an increased risk of developing pseudotumor cerebri syndrome (PTCS). We identified patients in the University of Utah Health system who were prescribed a tetracycline-class antibiotic and determined what percentage of those individuals were subsequently diagnosed with PTCS secondary to tetracycline use. We compared this calculation to the number of patients with PTCS unrelated to tetracycline use. Between 2007 and 2014, a total of 960 patients in the University system between the ages of 12 and 50 were prescribed a tetracycline antibiotic. Among those, 45 were diagnosed with tetracycline-induced PTCS. We estimate the incidence of tetracycline-induced PTCS to be 63.9 per 100,000 person-years. By comparison, the incidence of idiopathic intracranial hypertension (IIH) is estimated to be less than one per 100,000 person-years (Calculated Risk Ratio = 178). Although a causative link between tetracycline use and pseudotumor cerebri has yet to be firmly established, our study suggests that the incidence of pseudotumor cerebri among tetracycline users is significantly higher than the incidence of IIH in the general population.
Sections du résumé
BACKGROUND
To determine whether the use of a tetracycline-class antibiotic is associated with an increased risk of developing pseudotumor cerebri syndrome (PTCS).
METHODS
We identified patients in the University of Utah Health system who were prescribed a tetracycline-class antibiotic and determined what percentage of those individuals were subsequently diagnosed with PTCS secondary to tetracycline use. We compared this calculation to the number of patients with PTCS unrelated to tetracycline use.
RESULTS
Between 2007 and 2014, a total of 960 patients in the University system between the ages of 12 and 50 were prescribed a tetracycline antibiotic. Among those, 45 were diagnosed with tetracycline-induced PTCS. We estimate the incidence of tetracycline-induced PTCS to be 63.9 per 100,000 person-years. By comparison, the incidence of idiopathic intracranial hypertension (IIH) is estimated to be less than one per 100,000 person-years (Calculated Risk Ratio = 178).
CONCLUSIONS
Although a causative link between tetracycline use and pseudotumor cerebri has yet to be firmly established, our study suggests that the incidence of pseudotumor cerebri among tetracycline users is significantly higher than the incidence of IIH in the general population.
Identifiants
pubmed: 35427251
doi: 10.1097/WNO.0000000000001536
pii: 00041327-990000000-00027
pmc: PMC9588410
mid: NIHMS1759933
doi:
Substances chimiques
Anti-Bacterial Agents
0
Tetracycline
F8VB5M810T
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
323-327Subventions
Organisme : AHRQ HHS
ID : R01 HS019862
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002538
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001067
Pays : United States
Organisme : NCRR NIH HHS
ID : UL1 RR025764
Pays : United States
Organisme : NEI NIH HHS
ID : T35 EY026511
Pays : United States
Informations de copyright
Copyright © 2022 by North American Neuro-Ophthalmology Society.
Déclaration de conflit d'intérêts
S. F. Passi and D. R. Orme were supported by T35 EY026511 (NEI/NIH) “Medical Student Research Program in Eye Health and Disease”; Principal Investigator Mary Elizabeth Hartnett. FURTHeR is supported by NCRR/ NCATS Grants UL1RR025764 and 3UL1RR025764-02S2, National Center for Clinical and Translational Science 1UL1TR001067, University of Utah Research Foundation, grant 1D1BRH20425 (DHHS), and R01 HS019862 from AHRQ, (DHHS). K. B. Digre, J. E. A. Warner and B. J. Katz are named on a patent or patents related to the treatment of photophobia. B. J. Katz is CEO of Axon Optics, LLC, an internet company that sells eyewear for the treatment of photophobia. B. J. Katz provides expert medical testimony in legal proceedings and some of these proceedings involve the treatment of PTCS. The remaining authors report no conflicts of interest.
Références
AMIA Annu Symp Proc. 2009 Nov 14;2009:70-4
pubmed: 20351825
Exp Dermatol. 2015 Jun;24(6):473-6
pubmed: 25810318
Acta Neurol Scand. 2004 Dec;110(6):408-11
pubmed: 15527455
Am J Ophthalmol. 1998 Jul;126(1):116-21
pubmed: 9683157
Dermatol Clin. 2009 Jan;27(1):33-42
pubmed: 18984366
J Neuroophthalmol. 2007 Dec;27(4):258-62
pubmed: 18090557
J Am Acad Dermatol. 2019 Aug;81(2):456-462
pubmed: 30905802
Neurology. 2004 Jun 22;62(12):2297-9
pubmed: 15210900
Am J Ophthalmol. 2020 Dec;220:177-182
pubmed: 32738227
J Neurol Neurosurg Psychiatry. 2012 May;83(5):488-94
pubmed: 22423118
Harefuah. 1994 Jul;127(1-2):9-11, 64
pubmed: 7959395
Neurology. 1995 Jan;45(1):6-10
pubmed: 7824136
Br Med J (Clin Res Ed). 1981 Jan 3;282(6257):19-20
pubmed: 6449976
Arch Neurol. 1988 Aug;45(8):875-7
pubmed: 3395261
J Am Acad Dermatol. 2006 Feb;54(2):258-65
pubmed: 16443056
J AAPOS. 1999 Feb;3(1):53-7
pubmed: 10071902
Arch Ophthalmol. 2007 Aug;125(8):1137-8
pubmed: 17698769
Neuroophthalmology. 2014 Jul 24;38(5):249-253
pubmed: 27928307
Curr Treat Options Neurol. 2013 Feb;15(1):1-12
pubmed: 23136035
Acta Neurol Scand. 2017 Nov;136(5):427-433
pubmed: 28244170
Eur Neurol. 1978;17(1):48-9
pubmed: 624295