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Common Antibiotic Raises Risk of Aortic Aneurysm

Treatment with the antibiotic fluoroquinolone is associated with an increased risk of aortic aneurysm or dissection, according to a recent study.
From July 2006 to December 2013, researchers evaluated 360,088 treatment episodes of fluoroquinolone use (78% ciprofloxacin), as well as 360,088 propensity score-matched episodes of amoxicillin use for comparison.
Hazard ratios (HR) for a first diagnosis of aortic aneurysm or dissection were estimated via Cox regression.
Findings revealed that fluoroquinolone use was associated with an increased risk of aortic aneurysm or dissection (HR 1.66) compared with amoxicillin use (estimated absolute difference: 82 cases of aortic aneurysm or dissection by 60 days per 1 million treatment episodes).
Within the 60-day risk period, aortic aneurysm or dissection had occurred at a rate of 1.2 cases per 1000 person-years in fluoroquinolone users compared with 0.7 cases per 1000 person-years in amoxicillin users.
In a secondary analysis, the HRs for the association with fluoroquinolone use were 1.90 and 0.93 for aortic aneurysm and aortic dissection, respectively.
“In a propensity score matched cohort, fluoroquinolone use was associated with an increased risk of aortic aneurysm or dissection,” the researchers concluded. “This association appeared to be largely driven by aortic aneurysm.”

REFERENCE: 
Pasternak B, Inghammar M, Svanström H, et al. Fluoroquinolone use and risk of aortic aneurysm and dissection: nationwide cohort study [Published online March 8, 2018]. BMJ. https://doi.org/10.1136/bmj.k678.

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