Fluoroquinolone does not contribute to increased risk of intracranial aneurysm, dissection

Exposure to fluoroquinolone does not confer an excess risk of intracranial aneurysm or dissection, a study has found.

The study used data from the French National Insurance databases covering >60 million inhabitants and included 7,443 adult patients with first ruptured intracranial aneurysm and dissection. For each patient, fluoroquinolone use was compared between the exposure-risk window (day 30–day 1 before the outcome) and matched control windows (day 120–day 91, day 150–day 121, and day 180–day 151). Researchers established an age- and sex-matched reference group of amoxicillin users.

Seventy-five patients (median age, 55 years; 66.7 percent female) had been exposed to fluoroquinolones in the previous 180 days, including 16 in the 30-day at-risk window. Three-hundred eighty-five cases were exposed to amoxicillin (median age, 53 years; 62.1 percent female), including 97 exposed in the 30-day at-risk window.

The adjusted odds ratios (ORs) for the risk of intracranial aneurysm or dissection associated with fluoroquinolones and amoxicillin were 1.26 (95 percent confidence interval [CI], 0.65–2.41) and 1.36 (95 percent CI, 1.05–1.78), respectively.

The ratio of OR related to fluoroquinolones to that related to amoxicillin was approximately 0.92 (95 percent CI, 0.46–1.86). Result did not differ when extending outcome definition to unruptured events (ratio of OR, 0.97, 95 percent CI, 0.61–1.53).

The present data show no evidence of an increased short-term risk of intracranial aneurysm or dissection associated with the use of systemic fluoroquinolone vs amoxicillin, the researchers said.