OBJECTIVES: Fluoroquinolones, nitrofurantoin, metronidazole, and linezolid are known to be associated with peripheral neuropathy. Other antibiotics may also cause peripheral neuropathy, but no study to date has systematically evaluated many available antibiotics for their association with peripheral neuropathy. Therefore, the objective of this study was to systematically evaluate the association between peripheral neuropathy and many available antibiotics using the FDA Adverse Event Reporting System (FAERS).

METHODS: FAERS reports from January 1, 2015 to December 31, 2017 were included in the study. The Medical Dictionary for Regulatory Activities (MedDRA) was used to identify peripheral neuropathy cases. Reporting Odds Ratios (RORs) and corresponding 95% confidence intervals (95%CI) for the association between antibiotics and peripheral neuropathy were calculated. An association was considered to be statistically significant when the lower limit of the 95%CI was greater than 1.

RESULTS: A total of 2,042,801 reports (including 20,011 peripheral neuropathy reports) were considered, after inclusion criteria were applied. Fluoroquinolones had the greatest proportion of peripheral neuropathy reports of all antibiotics studied, representing 14% of all fluoroquinolone reports. Peripheral neuropathy RORs (95%CI) were statistically significant for (in descending order): fluoroquinolones 17.56 (16.65-18.51), cefoxitin 7.90 (3.18-19.63), nitrofurantoin 5.07 (3.39-7.58), metronidazole 3.75 (2.98-4.72), linezolid 2.96 (2.10-4.16), and amikacin 2.31 (1.09-4.89).

CONCLUSIONS: We confirmed four known associations (fluoroquinolones, nitrofurantoin, metronidazole, and linezolid) and discovered two new associations (cefoxitin and amikacin) between antibiotics and peripheral neuropathy. Additional studies are warranted to confirm or refute these findings.