Publication related to RSI or an RSI staff member
Systemic quinolones and risk of acute liver failure I: Analysis of data from the US FDA adverse event reporting system.
BACKGROUND AND AIM: Quinolones are a potent and globally popular group of antibiotics that are used to treat a wide range of infections. Some case reports have raised concern about their possible association with acute hepatic failure (AHF). Data from the US FDA Adverse Event Reporting System were evaluated for signals of AHF in association with systemically administered quinolone antibiotics. METHODS: AHF reports between 1969 and 2019q2, with a focus on 2010-2019q2, were analyzed. Specifically, AHF reports linked to non-quinolone antibiotics of known hepatotoxicity were compared to reports with non-quinolone, non-hepatotoxic (reference) antibiotics; and AHF reports with quinolones were also compared to reports with the same group of reference antibiotics. Two disproportionality signal detection techniques (proportional reporting ratio, PRR, and empirical Bayes geometric mean, EBGM) were used to assess the AHF signal for both analyses. RESULTS: Only ciprofloxacin showed a marginal and significant AHF signal (PRR: 1.85 [1.21, 2.81]; EBGM: 1.54 [1.06, 1.81]); moxifloxacin, levofloxacin, and ofloxacin showed weak and nonsignificant signals. CONCLUSION: Further pharmacovigilance studies are required to confirm the association between ciprofloxacin and AHF seen in the present analysis.
Authors
- Taher, Mohamed Kadry, Taher MK, McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine University of Ottawa Ottawa ON Canada.; School of Epidemiology and Public Health University of Ottawa Ottawa ON Canada.; Risk Sciences International Ottawa ON Canada.
- Alami, Abdallah, Alami A, Risk Sciences International Ottawa ON Canada.
- Gravel, Christopher A, Gravel CA, McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine University of Ottawa Ottawa ON Canada.; School of Epidemiology and Public Health University of Ottawa Ottawa ON Canada.; Department of Epidemiology, Biostatistics and Occupational Health McGill University Montreal QC Canada.
- Tsui, Derek, Tsui D, Risk Sciences International Ottawa ON Canada.
- Bjerre, Lise M, Bjerre LM, School of Epidemiology and Public Health University of Ottawa Ottawa ON Canada.; Department of Family Medicine University of Ottawa Ottawa ON Canada.; C.T. Lamont Primary Health Care Research Centre Bruyère Research Institute Ottawa ON Canada.
- Momoli, Franco, Momoli F, School of Epidemiology and Public Health University of Ottawa Ottawa ON Canada.; Risk Sciences International Ottawa ON Canada.; Children's Hospital of Eastern Ontario Research Institute Ottawa ON Canada.
- Mattison, Donald R, Mattison DR, McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine University of Ottawa Ottawa ON Canada.; Risk Sciences International Ottawa ON Canada.
- Krewski, Daniel, Krewski D, McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine University of Ottawa Ottawa ON Canada.; School of Epidemiology and Public Health University of Ottawa Ottawa ON Canada.; Risk Sciences International Ottawa ON Canada.
BACKGROUND AND AIM: Quinolones are a potent and globally popular group of antibiotics that are used to treat a wide range of infections. Some case reports have raised concern about their possible association with acute hepatic failure (AHF). Data from the US FDA Adverse Event Reporting System were evaluated for signals of AHF in association with systemically administered quinolone antibiotics. METHODS: AHF reports between 1969 and 2019q2, with a focus on 2010-2019q2, were analyzed. Specifically, AHF reports linked to non-quinolone antibiotics of known hepatotoxicity were compared to reports with non-quinolone, non-hepatotoxic (reference) antibiotics; and AHF reports with quinolones were also compared to reports with the same group of reference antibiotics. Two disproportionality signal detection techniques (proportional reporting ratio, PRR, and empirical Bayes geometric mean, EBGM) were used to assess the AHF signal for both analyses. RESULTS: Only ciprofloxacin showed a marginal and significant AHF signal (PRR: 1.85 [1.21, 2.81]; EBGM: 1.54 [1.06, 1.81]); moxifloxacin, levofloxacin, and ofloxacin showed weak and nonsignificant signals. CONCLUSION: Further pharmacovigilance studies are required to confirm the association between ciprofloxacin and AHF seen in the present analysis.
