Association between peripheral neuropathy and exposure to oral fluoroquinolone or amoxicillin-clavulanate therapy
JAMA Jul 14, 2019
Morales D, et al. - Via a nested case-control study of 5,357 incident peripheral neuropathy cases and 17,285 matched controls taken from The Health Improvement Network database, a large primary care population database in the United Kingdom, from January 1, 1999, to December 31, 2015, the researchers determined the relative and absolute risk estimates for the association of fluoroquinolone exposure with peripheral neuropathy and assessed how risk could be influenced by the timing of fluoroquinolone exposure and by other risk factors. In comparison with non-exposure, current oral fluoroquinolone exposure was affiliated with an elevated relative incidence of peripheral neuropathy. For each new day of current fluoroquinolone exposure, risk progressed by approximately 3% and continued for up to 180 days after exposure. No meaningful progressed risk was recognized with oral amoxicillin-clavulanate exposure. Per 10,000 patients per year of prevailing use, the absolute risk with current oral fluoroquinolone exposure was 2.4. The number required to harm for a 10-day course was 152,083 patients and was maximum among men and among subjects older than 60 years. Hence, oral fluoroquinolone therapy was concluded as correlated with an elevated risk of incident peripheral neuropathy that could depend on the timing of the exposure and the cumulative dose. Moreover, when prescribing fluoroquinolone antibiotics, these potential risks should be taken into account by health care professionals.
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