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Association between initiation of fluoroquinolones and hospital admission or emergency department visit for suicidality: population based cohort study
OBJECTIVE: To evaluate the association between initiation of fluoroquinolones and hospital admission or emergency department visit for suicidality. DESIGN: Population based cohort study. SETTING: IBM MarketScan database, USA. PARTICIPANTS: 2 756 268 adults (≥18 years) who initiated an oral fluoroqui...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group Ltd.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9530980/ https://www.ncbi.nlm.nih.gov/pubmed/36195324 http://dx.doi.org/10.1136/bmj-2021-069931 |
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author | Wang, Junyi Gagne, Joshua J Kattinakere-Sreedhara, Sushama Fischer, Michael A Bykov, Katsiaryna |
author_facet | Wang, Junyi Gagne, Joshua J Kattinakere-Sreedhara, Sushama Fischer, Michael A Bykov, Katsiaryna |
author_sort | Wang, Junyi |
collection | PubMed |
description | OBJECTIVE: To evaluate the association between initiation of fluoroquinolones and hospital admission or emergency department visit for suicidality. DESIGN: Population based cohort study. SETTING: IBM MarketScan database, USA. PARTICIPANTS: 2 756 268 adults (≥18 years) who initiated an oral fluoroquinolone (ciprofloxacin, levofloxacin, moxifloxacin, gemifloxacin, ofloxacin, gatifloxacin, norfloxacin, lomefloxacin, besifloxacin) or comparator antibiotic (January 2003 to September 2015) and had at least six months of continuous health plan enrollment and a diagnosis of pneumonia or urinary tract infection (UTI) three days or less before the drug initiation date. Comparator antibiotics were azithromycin in the pneumonia cohort and trimethoprim-sulfamethoxazole in the UTI cohort. Participants were matched 1:1 within each cohort on a propensity score, calculated from a multivariable logistic regression model that included 57 baseline covariates. MAIN OUTCOMES MEASURE: Primary outcome was hospital admission or emergency department visit for suicidal ideation or self-harm within 60 days after treatment initiation. Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals. RESULTS: The pneumonia cohort included 551 042 individuals, and the UTI cohort included 2 205 526 individuals. During the 60 day follow-up, 181 events were observed in the pneumonia cohort and 966 in the UTI cohort. The adjusted hazard ratios for fluoroquinolones were 1.01 (95% confidence interval 0.76 to 1.36) versus azithromycin in the pneumonia cohort and 1.03 (0.91 to 1.17) versus trimethoprim-sulfamethoxazole in the UTI cohort. Results were consistent across sensitivity analyses and subgroups of sex, age, or history of mental illnesses. CONCLUSION: Initiation of fluoroquinolones was not associated with a substantially increased risk of admission to hospital or emergency department visits for suicidality compared with azithromycin or trimethoprim-sulfamethoxazole. |
format | Online Article Text |
id | pubmed-9530980 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-95309802022-10-05 Association between initiation of fluoroquinolones and hospital admission or emergency department visit for suicidality: population based cohort study Wang, Junyi Gagne, Joshua J Kattinakere-Sreedhara, Sushama Fischer, Michael A Bykov, Katsiaryna BMJ Research OBJECTIVE: To evaluate the association between initiation of fluoroquinolones and hospital admission or emergency department visit for suicidality. DESIGN: Population based cohort study. SETTING: IBM MarketScan database, USA. PARTICIPANTS: 2 756 268 adults (≥18 years) who initiated an oral fluoroquinolone (ciprofloxacin, levofloxacin, moxifloxacin, gemifloxacin, ofloxacin, gatifloxacin, norfloxacin, lomefloxacin, besifloxacin) or comparator antibiotic (January 2003 to September 2015) and had at least six months of continuous health plan enrollment and a diagnosis of pneumonia or urinary tract infection (UTI) three days or less before the drug initiation date. Comparator antibiotics were azithromycin in the pneumonia cohort and trimethoprim-sulfamethoxazole in the UTI cohort. Participants were matched 1:1 within each cohort on a propensity score, calculated from a multivariable logistic regression model that included 57 baseline covariates. MAIN OUTCOMES MEASURE: Primary outcome was hospital admission or emergency department visit for suicidal ideation or self-harm within 60 days after treatment initiation. Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals. RESULTS: The pneumonia cohort included 551 042 individuals, and the UTI cohort included 2 205 526 individuals. During the 60 day follow-up, 181 events were observed in the pneumonia cohort and 966 in the UTI cohort. The adjusted hazard ratios for fluoroquinolones were 1.01 (95% confidence interval 0.76 to 1.36) versus azithromycin in the pneumonia cohort and 1.03 (0.91 to 1.17) versus trimethoprim-sulfamethoxazole in the UTI cohort. Results were consistent across sensitivity analyses and subgroups of sex, age, or history of mental illnesses. CONCLUSION: Initiation of fluoroquinolones was not associated with a substantially increased risk of admission to hospital or emergency department visits for suicidality compared with azithromycin or trimethoprim-sulfamethoxazole. BMJ Publishing Group Ltd. 2022-10-04 /pmc/articles/PMC9530980/ /pubmed/36195324 http://dx.doi.org/10.1136/bmj-2021-069931 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Research Wang, Junyi Gagne, Joshua J Kattinakere-Sreedhara, Sushama Fischer, Michael A Bykov, Katsiaryna Association between initiation of fluoroquinolones and hospital admission or emergency department visit for suicidality: population based cohort study |
title | Association between initiation of fluoroquinolones and hospital admission or emergency department visit for suicidality: population based cohort study |
title_full | Association between initiation of fluoroquinolones and hospital admission or emergency department visit for suicidality: population based cohort study |
title_fullStr | Association between initiation of fluoroquinolones and hospital admission or emergency department visit for suicidality: population based cohort study |
title_full_unstemmed | Association between initiation of fluoroquinolones and hospital admission or emergency department visit for suicidality: population based cohort study |
title_short | Association between initiation of fluoroquinolones and hospital admission or emergency department visit for suicidality: population based cohort study |
title_sort | association between initiation of fluoroquinolones and hospital admission or emergency department visit for suicidality: population based cohort study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9530980/ https://www.ncbi.nlm.nih.gov/pubmed/36195324 http://dx.doi.org/10.1136/bmj-2021-069931 |
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