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Risk of acute liver injury associated with the use of moxifloxacin and other oral antimicrobials: a retrospective, population-based cohort study.

Kaye JA, Castellsague J, Bui CL, Calingaert B, McQuay LJ, Riera-Guardia N, Saltus CW, Quinlan S, Holick CN, Wahl PM, Suzart K, Rothman KJ, Wallander MA, Perez-Gutthann S - Pharmacotherapy (2013)

Bottom Line: Levofloxacin had the highest relative risk for current single use (3.2, 95% CI 1.8-5.8).Relative risks were also elevated for amoxicillin-clavulanic acid (2.5, 95% CI 1.3-5.0), doxycycline (2.5, 95% CI 1.2-5.2), moxifloxacin (2.3, 95% CI 1.1-4.7), and amoxicillin (2.3, 95% CI 1.1-4.7).The results support a comparatively high adjusted relative risk of liver injury among patients exposed concurrently to multiple antimicrobials and modest elevations in the risk for several antimicrobials used alone; however, we found little evidence of any strong effect of commonly used antimicrobials on the risk of liver injury.

View Article: PubMed Central - PubMed

Affiliation: Epidemiology, RTI Health Solutions, Waltham, Massachusetts.

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Related in: MedlinePlus

Flow diagram of the case validation results. “Potential” cases met the claims diagnosis screening criteria. Percentages in the boxes refer to the percentage of the total 715 potential cases, whereas percentages outside of boxes refer to percentage of the patients in the preceding box of the flow diagram. Exclusion diagnoses for the 21 potential cases determined not to be valid cases were identified during review of hospital and emergency records. (Patients who had exclusion diagnoses in their claims data were not considered to be potential cases.) “Valid” cases were those confirmed to meet all case definition criteria by review of hospital or emergency department records.
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fig01: Flow diagram of the case validation results. “Potential” cases met the claims diagnosis screening criteria. Percentages in the boxes refer to the percentage of the total 715 potential cases, whereas percentages outside of boxes refer to percentage of the patients in the preceding box of the flow diagram. Exclusion diagnoses for the 21 potential cases determined not to be valid cases were identified during review of hospital and emergency records. (Patients who had exclusion diagnoses in their claims data were not considered to be potential cases.) “Valid” cases were those confirmed to meet all case definition criteria by review of hospital or emergency department records.

Mentions: In screening, we found 715 potential cases of liver injury. Case validation results are shown in Figure1. Of the 420 cases with adequate records, 312 were valid and 108 were not cases; 295 were of uncertain status (as defined earlier).


Risk of acute liver injury associated with the use of moxifloxacin and other oral antimicrobials: a retrospective, population-based cohort study.

Kaye JA, Castellsague J, Bui CL, Calingaert B, McQuay LJ, Riera-Guardia N, Saltus CW, Quinlan S, Holick CN, Wahl PM, Suzart K, Rothman KJ, Wallander MA, Perez-Gutthann S - Pharmacotherapy (2013)

Flow diagram of the case validation results. “Potential” cases met the claims diagnosis screening criteria. Percentages in the boxes refer to the percentage of the total 715 potential cases, whereas percentages outside of boxes refer to percentage of the patients in the preceding box of the flow diagram. Exclusion diagnoses for the 21 potential cases determined not to be valid cases were identified during review of hospital and emergency records. (Patients who had exclusion diagnoses in their claims data were not considered to be potential cases.) “Valid” cases were those confirmed to meet all case definition criteria by review of hospital or emergency department records.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4260122&req=5

fig01: Flow diagram of the case validation results. “Potential” cases met the claims diagnosis screening criteria. Percentages in the boxes refer to the percentage of the total 715 potential cases, whereas percentages outside of boxes refer to percentage of the patients in the preceding box of the flow diagram. Exclusion diagnoses for the 21 potential cases determined not to be valid cases were identified during review of hospital and emergency records. (Patients who had exclusion diagnoses in their claims data were not considered to be potential cases.) “Valid” cases were those confirmed to meet all case definition criteria by review of hospital or emergency department records.
Mentions: In screening, we found 715 potential cases of liver injury. Case validation results are shown in Figure1. Of the 420 cases with adequate records, 312 were valid and 108 were not cases; 295 were of uncertain status (as defined earlier).

Bottom Line: Levofloxacin had the highest relative risk for current single use (3.2, 95% CI 1.8-5.8).Relative risks were also elevated for amoxicillin-clavulanic acid (2.5, 95% CI 1.3-5.0), doxycycline (2.5, 95% CI 1.2-5.2), moxifloxacin (2.3, 95% CI 1.1-4.7), and amoxicillin (2.3, 95% CI 1.1-4.7).The results support a comparatively high adjusted relative risk of liver injury among patients exposed concurrently to multiple antimicrobials and modest elevations in the risk for several antimicrobials used alone; however, we found little evidence of any strong effect of commonly used antimicrobials on the risk of liver injury.

View Article: PubMed Central - PubMed

Affiliation: Epidemiology, RTI Health Solutions, Waltham, Massachusetts.

Show MeSH
Related in: MedlinePlus