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Article: Association between oral fluoroquinolones and seizures: a self-controlled case series study

TitleAssociation between oral fluoroquinolones and seizures: a self-controlled case series study
Authors
Issue Date2016
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.neurology.org
Citation
Neurology, 2016, v. 86 n. 18, p. 1708-1715 How to Cite?
AbstractObjectives: The aim of this study was to investigate the association and to estimate the crude absolute risk of seizure among patients exposed to fluoroquinolones (FQs) in Hong Kong and the United Kingdom. Methods: A self-controlled case series study was conducted. Data were collected from the Hong Kong Clinical Data Analysis and Reporting System database and the Clinical Practice Research Datalink. Patients who were prescribed any oral FQ and had an incident seizure diagnosis from 2001 to 2013 were included. The risk windows were defined as pre-FQ start, FQ-exposed, and post-FQ completion. Incidence rate ratios were estimated in all risk windows and compared with baseline periods. A post hoc subgroup analysis was conducted to examine the effect of patients with a history of seizure. Results: An increased incidence rate ratio was found in the pre-FQ start periods and no association was found in the post-FQ completion periods in both databases. The crude absolute risk of an incident seizure in 10,000 oral FQ prescriptions was 0.72 (95% confidence interval 0.47–1.10) in the Clinical Data Analysis and Reporting System and 0.40 (95% confidence interval 0.30–0.54) in the Clinical Practice Research Datalink. The rate ratio during treatment was not higher than pre-FQ start periods among patients with a history of seizure, therefore the results did not raise serious concerns. Conclusions: This study does not support a causal association between the use of oral FQs and the subsequent occurrence of seizure. An increased risk before the FQ exposure period suggests that the clinical indication for which FQ was prescribed may have contributed to the development of seizure rather than the drug itself.
Persistent Identifierhttp://hdl.handle.net/10722/229368
ISSN
2017 Impact Factor: 8.055
2015 SCImago Journal Rankings: 3.691
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChui, SLC-
dc.contributor.authorChan, EW-
dc.contributor.authorWong, YS-
dc.contributor.authorRoot, A-
dc.contributor.authorDouglas, IJ-
dc.contributor.authorWong, ICK-
dc.date.accessioned2016-08-23T14:10:43Z-
dc.date.available2016-08-23T14:10:43Z-
dc.date.issued2016-
dc.identifier.citationNeurology, 2016, v. 86 n. 18, p. 1708-1715-
dc.identifier.issn0028-3878-
dc.identifier.urihttp://hdl.handle.net/10722/229368-
dc.description.abstractObjectives: The aim of this study was to investigate the association and to estimate the crude absolute risk of seizure among patients exposed to fluoroquinolones (FQs) in Hong Kong and the United Kingdom. Methods: A self-controlled case series study was conducted. Data were collected from the Hong Kong Clinical Data Analysis and Reporting System database and the Clinical Practice Research Datalink. Patients who were prescribed any oral FQ and had an incident seizure diagnosis from 2001 to 2013 were included. The risk windows were defined as pre-FQ start, FQ-exposed, and post-FQ completion. Incidence rate ratios were estimated in all risk windows and compared with baseline periods. A post hoc subgroup analysis was conducted to examine the effect of patients with a history of seizure. Results: An increased incidence rate ratio was found in the pre-FQ start periods and no association was found in the post-FQ completion periods in both databases. The crude absolute risk of an incident seizure in 10,000 oral FQ prescriptions was 0.72 (95% confidence interval 0.47–1.10) in the Clinical Data Analysis and Reporting System and 0.40 (95% confidence interval 0.30–0.54) in the Clinical Practice Research Datalink. The rate ratio during treatment was not higher than pre-FQ start periods among patients with a history of seizure, therefore the results did not raise serious concerns. Conclusions: This study does not support a causal association between the use of oral FQs and the subsequent occurrence of seizure. An increased risk before the FQ exposure period suggests that the clinical indication for which FQ was prescribed may have contributed to the development of seizure rather than the drug itself.-
dc.languageeng-
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.neurology.org-
dc.relation.ispartofNeurology-
dc.rightsThis is a non-final version of an article published in final form in Neurology-
dc.titleAssociation between oral fluoroquinolones and seizures: a self-controlled case series study-
dc.typeArticle-
dc.identifier.emailChui, SLC: cslchui@hku.hk-
dc.identifier.emailChan, EW: ewchan@hku.hk-
dc.identifier.emailWong, ICK: wongick@hku.hk-
dc.identifier.authorityChan, EW=rp01587-
dc.identifier.authorityWong, ICK=rp01480-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1212/WNL.0000000000002633-
dc.identifier.pmid27053716-
dc.identifier.pmcidPMC4854590-
dc.identifier.scopuseid_2-s2.0-84966550910-
dc.identifier.hkuros260112-
dc.identifier.volume86-
dc.identifier.issue18-
dc.identifier.spage1708-
dc.identifier.epage1715-
dc.identifier.isiWOS:000377202100014-
dc.publisher.placeUnited States-

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