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TOPLINE:

A recent study found the use of systemic fluoroquinolone does not increase the risk for uveitis or retinal detachment.

METHODOLOGY:

• Researchers evaluated 3,001,256 and 434,754 adults in two primary care databases who were prescribed a fluoroquinolone antibiotic or cephalosporin between 1997 and 2019.
• They also performed self-controlled case series and compared the rate of events during exposed periods with those during unexposed periods within the same individual.
• A new prescription after a gap of more than 60 days was considered a new, separate episode of treatment.
• The primary outcomes were acute uveitis and retinal detachment.

TAKEAWAY:

• Use of a fluoroquinolone was not associated with risk for uveitis (pooled adjusted hazard ratio [aHR], 0.91; 95% CI, 0.72-1.14) or retinal detachment (aHR, 1.37; 95% CI, 0.80-2.36) at the first treatment episode compared with cephalosporin.
• The researchers found no association between uveitis or retinal detachment and fluoroquinolone use across all episodes of treatment.
• Exposure to fluoroquinolones increased the risk of developing uveitis within 30-59 days after the start of treatment compared with no exposure (adjusted rate ratio, 1.16; 95% CI, 1.00-1.34). However, no significant increased risk was observed during the first 29 days of exposure or after 60 days.
• The use of fluoroquinolone antibiotics did not lead to a higher risk for retinal detachment compared with no exposure to the drugs.

IN PRACTICE:

"These findings give no indication that systemic fluoroquinolone use is associated with substantively increased risk of retinal detachment or uveitis and indicate that any absolute increase in risk would be small," the authors wrote.

SOURCE:

The study led by Jeremy P. Brown, PhD, of the Department of Non-Communicable Disease Epidemiology at the London School of Hygiene and Tropical Medicine, London, England, was published online on May 30, 2024, in JAMA Ophthalmology.

LIMITATIONS:

Misclassification bias may be present. The study focused on a specific group without providing direct evidence of cause and effect; hence, the results may not be generalizable. The safety signals for moxifloxacin may lead to a confounding bias.

DISCLOSURES:

The study did not declare any funding source. Some authors reported receiving personal fees and grants and owning shares of various pharma companies.