%0 Journal Article
%A Wicherski, Julia
%A Peltner, Jonas
%A Becker, Cornelia
%A Schüssel, Katrin
%A Brückner, Gabriela
%A Schlotmann, Andreas
%A Schröder, Helmut
%A Kern, Winfried V
%A Haenisch, Britta
%T High risk for life-threatening adverse events of fluoroquinolones in young adults: a large German population-based cohort study.
%J BMC medicine
%V 23
%N 1
%@ 1741-7015
%C London
%I BioMed Central
%M DZNE-2025-00307
%P 76
%D 2025
%X Fluoroquinolone antibiotics have a high potential for serious adverse drug reactions, but real-world evidence in European patient cohorts is lacking. Therefore, we aim to examine the association between fluoroquinolone exposure and potentially life-threatening adverse events stratified by age and gender in Germany.We conducted an administrative cohort study using the active comparator new user design with a risk window up to 365 days between January 2013 and December 2019. Population-based longitudinal data from one of the largest German statutory health insurances were used. Episodes of newly dispensed fluoroquinolones (ciprofloxacin, levofloxacin, ofloxacin, moxifloxacin, norfloxacin, and enoxacin) were compared to other antibiotics (amoxicillin, amoxicillin clavulanic acid, azithromycin, cefuroxime, cephalexin, clindamycin, sulfamethoxazole-trimethoprim, and doxycycline). Endpoints were defined by incident diagnoses of aortic aneurysm/dissection, cardiac arrhythmia, hepatotoxicity, and all-cause mortality. Adjusted hazard ratios were estimated from piece-wise exponential additive mixed models with smooth non-linear effects for person-time and age and adjusted for comorbidities, year and quarter at index.The cohorts comprised 15,139,840; 11,760,159; 11,027,175; and 15,305,757 antibiotic episodes. Patients during fluoroquinolone episodes were older (59 versus 51 years) and more often female (58
%K Humans
%K Germany: epidemiology
%K Female
%K Male
%K Fluoroquinolones: adverse effects
%K Adult
%K Middle Aged
%K Anti-Bacterial Agents: adverse effects
%K Aged
%K Cohort Studies
%K Young Adult
%K Arrhythmias, Cardiac: chemically induced
%K Arrhythmias, Cardiac: epidemiology
%K Aortic Dissection: epidemiology
%K Aortic Dissection: chemically induced
%K Chemical and Drug Induced Liver Injury: epidemiology
%K Chemical and Drug Induced Liver Injury: etiology
%K Adolescent
%K Drug-Related Side Effects and Adverse Reactions: epidemiology
%K Age Factors
%K Risk Factors
%K Adverse drug reactions (Other)
%K Antibiotics (Other)
%K Cohort study (Other)
%K Fluoroquinolones (Other)
%K Real-world evidence (Other)
%K Fluoroquinolones (NLM Chemicals)
%K Anti-Bacterial Agents (NLM Chemicals)
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:39920723
%2 pmc:PMC11806691
%R 10.1186/s12916-025-03919-0
%U https://pub.dzne.de/record/276749