Mohit Sodhi1, Claire A Sheldon1, Bruce Carleton1, Mahyar Etminan2. 1. From the Department of Ophthalmology and Visual Sciences (M.S., C.A.S., M.E.), the Department of Experimental Medicine (M.S.), Division of Translational Therapeutics, Department of Pediatrics (B.C.), Faculty of Medicine, and BC Children's Hospital Research Institute (B.C.), University of British Columbia; and Pharmaceutical Outcomes Programme (B.C.), British Columbia Children's Hospital, Vancouver, Canada. 2. From the Department of Ophthalmology and Visual Sciences (M.S., C.A.S., M.E.), the Department of Experimental Medicine (M.S.), Division of Translational Therapeutics, Department of Pediatrics (B.C.), Faculty of Medicine, and BC Children's Hospital Research Institute (B.C.), University of British Columbia; and Pharmaceutical Outcomes Programme (B.C.), British Columbia Children's Hospital, Vancouver, Canada. etminanm@mail.ubc.ca.
Abstract
OBJECTIVE: To quantify the risk of secondary pseudotumor cerebri syndrome (PTCS) with fluoroquinolones. METHODS: A case-control study of people 15-60 years of age from the LifeLink Database (QuintilesIMS, Parsippany, NJ) was conducted. Cases had the first ICD-9-CM code for benign intracranial hypertension (BIH) as well as having received a procedure code for an MRI or CT scan and a lumbar puncture within 15 days or 30 days of the BIH code. For each case, 10 controls were selected using density-based sampling. Current users of fluoroquinolones received a prescription within 15 days or 30 days of the date of the diagnosis. For the sensitivity analysis, risk periods for 30 and 60 days were also examined. Adjusted rate ratios (RRs) were computed from a conditional logistic regression model. RESULTS: From a cohort of 6,110,723 people, there were 339 cases of PTCS and 3,390 corresponding controls. In the primary analysis, the adjusted RR for current users of fluoroquinolones for both the 15-day and 30-day definitions were 5.67 (95% confidence interval [CI] 2.72-11.83) and 4.15 (95% CI 2.29-7.50), respectively. The risk with tetracycline antibiotics was also increased, with RRs for 15 and 30 days of current use of 2.68 (0.89-8.11) and 3.64 (1.67-7.91), respectively. CONCLUSION: Our study suggests an increase in the risk of PTCS with current users of fluoroquinolones. Although this adverse event is rare, patients who experience symptoms of raised intracranial pressure including headaches, tinnitus, and double vision while taking fluoroquinolones should seek medical attention.
OBJECTIVE: To quantify the risk of secondary pseudotumor cerebri syndrome (PTCS) with fluoroquinolones. METHODS: A case-control study of people 15-60 years of age from the LifeLink Database (QuintilesIMS, Parsippany, NJ) was conducted. Cases had the first ICD-9-CM code for benign intracranial hypertension (BIH) as well as having received a procedure code for an MRI or CT scan and a lumbar puncture within 15 days or 30 days of the BIH code. For each case, 10 controls were selected using density-based sampling. Current users of fluoroquinolones received a prescription within 15 days or 30 days of the date of the diagnosis. For the sensitivity analysis, risk periods for 30 and 60 days were also examined. Adjusted rate ratios (RRs) were computed from a conditional logistic regression model. RESULTS: From a cohort of 6,110,723 people, there were 339 cases of PTCS and 3,390 corresponding controls. In the primary analysis, the adjusted RR for current users of fluoroquinolones for both the 15-day and 30-day definitions were 5.67 (95% confidence interval [CI] 2.72-11.83) and 4.15 (95% CI 2.29-7.50), respectively. The risk with tetracycline antibiotics was also increased, with RRs for 15 and 30 days of current use of 2.68 (0.89-8.11) and 3.64 (1.67-7.91), respectively. CONCLUSION: Our study suggests an increase in the risk of PTCS with current users of fluoroquinolones. Although this adverse event is rare, patients who experience symptoms of raised intracranial pressure including headaches, tinnitus, and double vision while taking fluoroquinolones should seek medical attention.
Authors: Anna Sundholm; Sarah Burkill; Elisabet Waldenlind; Shahram Bahmanyar; A Ingela M Nilsson Remahl Journal: Cephalalgia Date: 2020-05-25 Impact factor: 6.292
Authors: Anna Sundholm; Sarah Burkill; Elisabet Waldenlind; Shahram Bahmanyar; A Ingela M Nilsson Remahl Journal: Cephalalgia Date: 2021-08-18 Impact factor: 6.292
Authors: Susan P Mollan; Brendan Davies; Nick C Silver; Simon Shaw; Conor L Mallucci; Benjamin R Wakerley; Anita Krishnan; Swarupsinh V Chavda; Satheesh Ramalingam; Julie Edwards; Krystal Hemmings; Michelle Williamson; Michael A Burdon; Ghaniah Hassan-Smith; Kathleen Digre; Grant T Liu; Rigmor Højland Jensen; Alexandra J Sinclair Journal: J Neurol Neurosurg Psychiatry Date: 2018-06-14 Impact factor: 10.154