Journal Article

DZNE-2025-00936

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Association between fluoroquinolones and retinal detachment: insights from a large German health claims-based cohort study.

Wicherski, J. ; Peltner, J.DZNE* ; Becker, C. ; Schüssel, K. ; Brückner, G. ; Schlotmann, A. ; Schröder, H. ; Kern, W. V. ; Haenisch, B. (Last author)DZNE*

2025
BioMed Central London

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Please use a persistent id in citations: doi:10.1186/s12886-025-04284-5

Abstract: Real-world evidence on fluoroquinolone-associated retinal detachment is contradictory. Therefore, we aim to examine the association between newly prescribed fluoroquinolones and the occurrence of retinal detachment with recent data from a large central European country.A cohort study with an active comparator new user design was conducted. Dispensings of fluoroquinolone episodes were compared to a group of reference antibiotic episodes (amoxicillin, amoxicillin clavulanic acid, azithromycin, cefuroxime, cephalexin, clindamycin, sulfamethoxazole-trimethoprim, and doxycycline). Data from one of the largest statutory health insurances in Germany, the AOK, were used to follow up individuals with new antibiotic dispensing during the years 2014-2018 for the occurrence of retinal detachment. Piece-wise exponential additive mixed models adjusted for person-time, age, gender, comorbidities, year, and quarter at index were applied to estimate adjusted hazard ratios (aHR) with corresponding 95% confidence intervals (95% CI).In total, 15,232,585 antibiotic episodes were included in the cohort of which 0.05% episodes had an incident retinal detachment. The covariate-adjusted hazard ratio for fluoroquinolone episodes was 1.01 [0.95;1.08]. Likewise, in the propensity score-matched cohort the covariate-adjusted hazard ratio was 0.99 [0.92;1.07]. Moreover, there was little evidence for differences in age and gender subgroups, by follow-up time, selection of active comparator agent, dosage category, or censoring approach.This large German cohort study found no meaningful real-world evidence for the association between fluoroquinolones and retinal detachment compared to a group of active comparator antibiotics.

Keyword(s): Humans (MeSH) ; Fluoroquinolones: adverse effects (MeSH) ; Germany: epidemiology (MeSH) ; Female (MeSH) ; Male (MeSH) ; Retinal Detachment: epidemiology (MeSH) ; Retinal Detachment: chemically induced (MeSH) ; Middle Aged (MeSH) ; Anti-Bacterial Agents: adverse effects (MeSH) ; Aged (MeSH) ; Adult (MeSH) ; Incidence (MeSH) ; Cohort Studies (MeSH) ; Retrospective Studies (MeSH) ; Follow-Up Studies (MeSH) ; Young Adult (MeSH) ; Active comparator new user design ; Administrative cohort ; Adverse drug reactions ; Fluoroquinolones ; Real-world data ; Fluoroquinolones ; Anti-Bacterial Agents

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Contributing Institute(s):

1. Pharmacoepidemiology (AG Hänisch)

Research Program(s):

1. 354 - Disease Prevention and Healthy Aging (POF4-354) (POF4-354)

Appears in the scientific report 2025

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