Samuel F Passi1, Ryan Butcher, Daniel R Orme, Judith E A Warner, Gregory J Stoddard, Alison V Crum, Ramkiran Gouripeddi, Brian H Kirk, Kathleen B Digre, Bradley J Katz. 1. Department of Ophthalmology and Visual Sciences (SFP, RB, DRO, JEAW, AVC, BK, KBD, BJK), John A. Moran Eye Center, University of Utah, Salt Lake City, Utah; Department of Family and Preventive Medicine and Department of Orthopaedics (GJS), University of Utah, Salt Lake City, Utah; and Department of Biomedical Informatics and Center for Clinical and Translational Science (RG), University of Utah School of Medicine, Salt Lake City, Utah. Dr. Passi is now with the Eye Institute of Utah, Salt Lake City, UT. Dr. Butcher is now with the Data Science Services/Data Warehouse, Salt Lake City, Utah. Dr. Orme is now with the Department of Neurological Sciences, Rush University Medical Center, Chicago, IL. Dr. Kirk is now with the Department of Ophthalmology, University of Missouri School of Medicine, University Hospital, Columbia, MO.
Abstract
BACKGROUND: To determine whether the use of a tetracycline-class antibiotic is associated with an increased risk of developing pseudotumor cerebri syndrome (PTCS). METHODS: We identified patients in the University of Utah Health system who were prescribed a tetracycline-class antibiotic and determined what percentage of those individuals were subsequently diagnosed with PTCS secondary to tetracycline use. We compared this calculation to the number of patients with PTCS unrelated to tetracycline use. RESULTS: Between 2007 and 2014, a total of 960 patients in the University system between the ages of 12 and 50 were prescribed a tetracycline antibiotic. Among those, 45 were diagnosed with tetracycline-induced PTCS. We estimate the incidence of tetracycline-induced PTCS to be 63.9 per 100,000 person-years. By comparison, the incidence of idiopathic intracranial hypertension (IIH) is estimated to be less than one per 100,000 person-years (Calculated Risk Ratio = 178). CONCLUSIONS: Although a causative link between tetracycline use and pseudotumor cerebri has yet to be firmly established, our study suggests that the incidence of pseudotumor cerebri among tetracycline users is significantly higher than the incidence of IIH in the general population.
BACKGROUND: To determine whether the use of a tetracycline-class antibiotic is associated with an increased risk of developing pseudotumor cerebri syndrome (PTCS). METHODS: We identified patients in the University of Utah Health system who were prescribed a tetracycline-class antibiotic and determined what percentage of those individuals were subsequently diagnosed with PTCS secondary to tetracycline use. We compared this calculation to the number of patients with PTCS unrelated to tetracycline use. RESULTS: Between 2007 and 2014, a total of 960 patients in the University system between the ages of 12 and 50 were prescribed a tetracycline antibiotic. Among those, 45 were diagnosed with tetracycline-induced PTCS. We estimate the incidence of tetracycline-induced PTCS to be 63.9 per 100,000 person-years. By comparison, the incidence of idiopathic intracranial hypertension (IIH) is estimated to be less than one per 100,000 person-years (Calculated Risk Ratio = 178). CONCLUSIONS: Although a causative link between tetracycline use and pseudotumor cerebri has yet to be firmly established, our study suggests that the incidence of pseudotumor cerebri among tetracycline users is significantly higher than the incidence of IIH in the general population.
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