A retrospective cohort study among hospitalized veterans with community-acquired pneumonia provides estimates of the individual frequencies of adverse tendon event (TE), Clostridioides difficile infection (CDI), and aortic aneurysm/dissection (AAD) associated with use of fluorquinolones. Patient-level factors are used to predict these fluoroquinolone (FQ) adverse events of interest (FQAEIs) and develop clinical risk scores for them.
Clinical data were obtained from medical records of hospitalized patients with community-acquired pneumonia in the Upstate New York Veterans’ Healthcare Administration from 2011 to 2016. Occurrence of the adverse events was evaluated individually and as a composite.
“The study population consisted of 1,071 patients,” the authors write. “The overall incidence of FQAEI, TE, AAD, and CDI were 6.5%, 1.8%, 4.5%, and 0.3%, respectively. For each outcome evaluated, the probability of the event of interest was predicted by the presence of certain comorbidities, previous health care exposure, choice of specific FQ antibiotic, or therapy duration. Concomitant steroids, pneumonia in preceding 180 days, and creatinine clearance <30 mL/min predicted FQAEI.”