TY  - JOUR
AU  - Wicherski, Julia
AU  - Peltner, Jonas
AU  - Becker, Cornelia
AU  - Schüssel, Katrin
AU  - Brückner, Gabriela
AU  - Schlotmann, Andreas
AU  - Schröder, Helmut
AU  - Kern, Winfried V
AU  - Haenisch, Britta
TI  - Fluoroquinolones and the risk of aortic aneurysm or dissection: A population-based propensity score-matched German cohort study.
JO  - Pharmacotherapy
VL  - 45
IS  - 6
SN  - 0277-0008
CY  - Hoboken, NJ
PB  - Wiley-Blackwell
M1  - DZNE-2025-00683
SP  - 314 - 323
PY  - 2025
AB  - To investigate the risk of aortic aneurysm or dissection associated with fluoroquinolone (FQ) prescription compared to macrolides in German routine health care data in order to replicate the recent study (Pharmacotherapy 2023;43:883) extending the results by contributing evidence for six additional broad-spectrum antibiotic classes as active comparators.Cohort study in active comparator new user design comparing FQ with macrolides, tetracyclines, penicillins with extended spectrum, penicillins and beta-lactamase inhibitor combinations, second- and third-generation cephalosporins, sulfonamide and trimethoprim combinations, and lincosamides.German statutory health insurance, the 'Allgemeine Ortskrankenkasse' (AOK), January 2013 to December 2019.Adults with at least one new prescription fill for FQ or active comparator antibiotics. New users were defined as individuals without antibiotic prescription fills, aortic aneurysm or dissection diagnoses, and hospitalization within 365 days prior to the cohort entry date. Users of FQ and active comparators were matched by nearest neighbor 1:1 propensity score matching.Incident inpatient aortic aneurysm or dissection was observed within a 60-day risk window. In sensitivity analyses, an extended risk window of 90 days was applied, and specific FQ agents, dosages, and diagnoses were stratified.FQ episodes were associated with an increased risk for aortic aneurysm or dissection compared to macrolides (aHR = 1.52 [1.33; 1.74]), which replicates the risk estimate of Garg et al. (aHR = 1.34 [1.17; 1.54]). This association was robust in a 90-day risk window and for ciprofloxacin, levofloxacin, and moxifloxacin. Moxifloxacin comprised the greatest risk of aortic aneurysm or dissection compared to macrolides (aHR = 2.13 [1.64; 2.77]). Moreover, we observed similar associations when comparing FQ to tetracyclines, penicillins with extended spectrum, cephalosporins, and lincosamides (aHR = 1.86 [1.54; 2.24], aHR = 1.45 [1.28; 1.65], aHR = 1.23 [1.10; 1.37], and aHR = 1.73 [1.43; 2.11]), respectively.In a German cohort study, FQ use was associated with a 52
KW  - Humans
KW  - Fluoroquinolones: adverse effects
KW  - Fluoroquinolones: administration & dosage
KW  - Male
KW  - Female
KW  - Germany: epidemiology
KW  - Anti-Bacterial Agents: adverse effects
KW  - Anti-Bacterial Agents: administration & dosage
KW  - Propensity Score
KW  - Aged
KW  - Aortic Dissection: epidemiology
KW  - Aortic Dissection: chemically induced
KW  - Middle Aged
KW  - Cohort Studies
KW  - Aortic Aneurysm: epidemiology
KW  - Aortic Aneurysm: chemically induced
KW  - Macrolides: adverse effects
KW  - Adult
KW  - adverse drug reactions (Other)
KW  - aortic aneurysm (Other)
KW  - fluoroquinolones (Other)
KW  - macrolides (Other)
KW  - Fluoroquinolones (NLM Chemicals)
KW  - Anti-Bacterial Agents (NLM Chemicals)
KW  - Macrolides (NLM Chemicals)
LB  - PUB:(DE-HGF)16
C6  - pmid:40285433
DO  - DOI:10.1002/phar.70020
UR  - https://pub.dzne.de/record/279053
ER  -