THE USE OF FLUOROQUINOLONES AND MUSCULOSKELETAL ADVERSE EVENTS IN PEDIATRICS - A LONGITUDINAL COHORT STUDY
Author(s)
KIM Y, Kim E
Evidence-Based Research and Clinical Research Lab., Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul, Korea, Republic of (South)
OBJECTIVES: Pediatric use of FQs has been restricted due to early findings of FQ-associated weight-bearing joint damage in juvenile animals. However, the off-label pediatric use of FQ is thought to be common and increasing worldwide. Therefore, we analyzed prescription patterns of quinolone antibiotics in patients under 18 years and accessed the incidence and risk of musculoskeletal side effects in comparison to clarithromycin antibiotics. METHODS: Using the NHIS-NSC(National Health Insurance Service-National Sample Cohort) database, we extracted patients under 18 years from Feb 2002 to Dec 2011 who had been prescribed quinolone or clarithromycin. They were followed up for 90 days after the first exposure to the antibiotics. The risk of musculoskeletal side effects were analyzed and the risk of the two groups were compared using the Cox proportinal hazard model. RESULTS: Of 350,123 patients under the age of 18, 44,831 patients were prescribed systemic quinolones and 107,206 were prescribed clarithromycin. Musculoskeletal side effects occurred in 744 patients (1.6%) in the quinolone group and 928(0.9%) in the clarithromycin group, and the difference was statistically significant(P<.001). The result of the Cox proportional hazards model showed that the quinolone group had a higher risk although not statistically significant(HR: 1.034, 95% CI: 0.895-1.173). CONCLUSIONS: Although the frequency of musculoskeletal side effects was significantly higher in the fluoroquinolone group, the risk was not statistically significant when adjusted by risk factor. Attention should be paid to prescribing fluoroquinolone in children and further stuides may be necessary.
Conference/Value in Health Info
2018-09, ISPOR Asia Pacific 2018, Tokyo, Japan
Value in Health, Vol. 21, S2 (September 2018)
Code
PMS1
Topic
Epidemiology & Public Health
Topic Subcategory
Safety & Pharmacoepidemiology
Disease
Musculoskeletal Disorders