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US-based emergency department visits for fluoroquinolone-associated hypersensitivity reactions.
Pharmacoepidemiol Drug Saf. 2013 Oct; 22(10):1099-106.PD

Abstract

PURPOSE

To estimate the rate of hypersensitivity reactions per 100,000 prescription dispensings of fluoroquinolones based on care rendered in a nationally representative sample of US hospital emergency departments (ED).

METHODS

We analyzed the frequency of fluoroquinolone-associated hypersensitivity reactions using the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance system (2004-2010) in conjunction with US retail outpatient prescription data from IMS Health (2004-2010). We further categorized reaction severity into three subgroups (mild, moderate, and severe).

RESULTS

Based on 1422 cases of fluoroquinolone-associated hypersensitivity reactions and national drug utilization projections, we estimated risk of hypersensitivity reactions for moxifloxacin, ciprofloxacin, and levofloxacin. The absolute risk of a fluoroquinolone-related hypersensitivity reaction of any severity was low (44.0 (95% CI 34.8-53.3) ED visits/100,000 prescriptions); however, we identified a statistically significant difference in the relative risk (rate ratios) of seeking care in an ED attributed to moxifloxacin hypersensitivity compared to either levofloxacin or ciprofloxacin. For all reaction severities, the estimated ED visits/100,000 prescriptions were 141.3 (95% CI 99.9-182.7) for moxifloxacin, 40.8 (95% CI 31.5-50.0) for levofloxacin, and 26.3 (95% CI 20.8-31.9) for ciprofloxacin. When the rates were stratified by reaction severity category (mild or moderate-severe), moxifloxacin continued to be implicated in more ED visits per 100,000 prescriptions dispensed than either levofloxacin or ciprofloxacin.

CONCLUSION

Fluoroquinolones may cause hypersensitivity reactions requiring care in an ED, and relative to use, the rate of moxifloxacin-related hypersensitivity reactions is higher compared to levofloxacin or ciprofloxacin.

Authors+Show Affiliations

US Food and Drug Administration, Office of Surveillance and Epidemiology, Silver Spring, MD, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23963962

Citation

Jones, S Christopher, et al. "US-based Emergency Department Visits for Fluoroquinolone-associated Hypersensitivity Reactions." Pharmacoepidemiology and Drug Safety, vol. 22, no. 10, 2013, pp. 1099-106.
Jones SC, Budnitz DS, Sorbello A, et al. US-based emergency department visits for fluoroquinolone-associated hypersensitivity reactions. Pharmacoepidemiol Drug Saf. 2013;22(10):1099-106.
Jones, S. C., Budnitz, D. S., Sorbello, A., & Mehta, H. (2013). US-based emergency department visits for fluoroquinolone-associated hypersensitivity reactions. Pharmacoepidemiology and Drug Safety, 22(10), 1099-106. https://doi.org/10.1002/pds.3499
Jones SC, et al. US-based Emergency Department Visits for Fluoroquinolone-associated Hypersensitivity Reactions. Pharmacoepidemiol Drug Saf. 2013;22(10):1099-106. PubMed PMID: 23963962.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - US-based emergency department visits for fluoroquinolone-associated hypersensitivity reactions. AU - Jones,S Christopher, AU - Budnitz,Daniel S, AU - Sorbello,Alfred, AU - Mehta,Hina, Y1 - 2013/08/20/ PY - 2013/04/30/received PY - 2013/07/03/revised PY - 2013/07/18/accepted PY - 2013/8/22/entrez PY - 2013/8/22/pubmed PY - 2014/5/3/medline KW - allergy KW - ciprofloxacin KW - fluoroquinolone KW - hypersensitivity KW - levofloxacin KW - moxifloxacin KW - pharmacoepidemiology SP - 1099 EP - 106 JF - Pharmacoepidemiology and drug safety JO - Pharmacoepidemiol Drug Saf VL - 22 IS - 10 N2 - PURPOSE: To estimate the rate of hypersensitivity reactions per 100,000 prescription dispensings of fluoroquinolones based on care rendered in a nationally representative sample of US hospital emergency departments (ED). METHODS: We analyzed the frequency of fluoroquinolone-associated hypersensitivity reactions using the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance system (2004-2010) in conjunction with US retail outpatient prescription data from IMS Health (2004-2010). We further categorized reaction severity into three subgroups (mild, moderate, and severe). RESULTS: Based on 1422 cases of fluoroquinolone-associated hypersensitivity reactions and national drug utilization projections, we estimated risk of hypersensitivity reactions for moxifloxacin, ciprofloxacin, and levofloxacin. The absolute risk of a fluoroquinolone-related hypersensitivity reaction of any severity was low (44.0 (95% CI 34.8-53.3) ED visits/100,000 prescriptions); however, we identified a statistically significant difference in the relative risk (rate ratios) of seeking care in an ED attributed to moxifloxacin hypersensitivity compared to either levofloxacin or ciprofloxacin. For all reaction severities, the estimated ED visits/100,000 prescriptions were 141.3 (95% CI 99.9-182.7) for moxifloxacin, 40.8 (95% CI 31.5-50.0) for levofloxacin, and 26.3 (95% CI 20.8-31.9) for ciprofloxacin. When the rates were stratified by reaction severity category (mild or moderate-severe), moxifloxacin continued to be implicated in more ED visits per 100,000 prescriptions dispensed than either levofloxacin or ciprofloxacin. CONCLUSION: Fluoroquinolones may cause hypersensitivity reactions requiring care in an ED, and relative to use, the rate of moxifloxacin-related hypersensitivity reactions is higher compared to levofloxacin or ciprofloxacin. SN - 1099-1557 UR - https://www.unboundmedicine.com/medline/citation/23963962/US_based_emergency_department_visits_for_fluoroquinolone_associated_hypersensitivity_reactions_ L2 - https://doi.org/10.1002/pds.3499 DB - PRIME DP - Unbound Medicine ER -