ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2012
Fluoroquinolone therapy and idiosyncratic acute liver injury: a population-based study.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Fluoroquinolone-related adverse events resulting in health service use and costs: A systematic review.PloS one · 2019Pooled it
- Fluoroquinolones for the Prophylaxis of Spontaneous Bacterial Peritonitis in Patients with Liver Cirrhosis: Are They Losing Ground?Life (Basel, Switzerland) · 2025Review
- Clinical impact of Choosing Wisely Canada hepatology recommendations: an interrupted time-series analysis using data from GEMINI.BMJ open quality · 2025Article
- High risk for life-threatening adverse events of fluoroquinolones in young adults: a large German population-based cohort study.BMC medicine · 2025Article
- Oral Fluoroquinolone Use and the Risk of Acute Liver Injury: A Nationwide Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Healthcare costs and mortality associated with serious fluoroquinolone-related adverse reactions.Pharmacology research & perspectives · 2022Article
- Fluoroquinolone-associated suspected tendonitis and tendon rupture: A pharmacovigilance analysis from 2016 to 2021 based on the FAERS database.Frontiers in pharmacology · 2022Article
- Dose- and time-dependent manners of moxifloxacin induced liver injury by targeted metabolomics study.Frontiers in pharmacology · 2022Article
- Moxifloxacin Induced Liver Injury by CausingDisease markers · 2022Article
- Association Between Drug Treatments and the Incidence of Liver Injury in Hospitalized Patients With COVID-19.Frontiers in pharmacology · 2022Article
- Difficulties in Diagnosing and Treating Disseminated Bacillus Calmette-Guérin (BCG) Infection After Intravesical BCG Therapy in a Patient with Liver Cirrhosis: A Case Report.The American journal of case reports · 2021Article
- Systemic quinolones and risk of acute liver failure III: A nested case-control study using a US electronic health records database.Journal of gastroenterology and hepatology · 2021Article
- [Safety in the selection of oral antibiotic treatment in community infections, beyond COVID-19].Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2021Review
- A Pharmacology Perspective of Simultaneous Tuberculosis and Hepatitis C Treatment.Antimicrobial agents and chemotherapy · 2019Review
- Incidence, clinical features, and risk factors of fluoroquinolone-induced acute liver injury: a case-control study.Therapeutics and clinical risk management · 2019Article
- Idiosyncratic Drug-Induced Liver Injury Due to Ciprofloxacin: A Report of Two Cases and Review of the Literature.The American journal of case reports · 2018Review
- A case report of nifedipine-induced hepatitis with jaundice.BMC research notes · 2018Article
- A Case of Levofloxacin-Induced Hepatotoxicity.The American journal of case reports · 2018Article
- Antibiotic-Induced Liver Injury in Paediatric Outpatients: A Case-Control Study in Primary Care Databases.Drug safety · 2017Article
- Antituberculosis Drug-Induced Liver Injury with Autoimmune Features: Facing Diagnostic and Treatment Challenges.Case reports in pediatrics · 2017Article
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5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAlthough fluoroquinolones are sometimes associated with mild, transient elevations in aminotransferase levels, serious acute liver injury is uncommon. Regulatory warnings have identified moxifloxacin as presenting a particular risk of hepatotoxicity. Thus, we examined the risk of idiosyncratic acute liver injury associated with the use of moxifloxacin relative to other selected antibiotic agents.
methodsWe conducted a population-based, nested, case-control study using health care data from Ontario for the period April 2002 to March 2011. We identified cases as outpatients aged 66 years or older with no history of liver disease, and who were admitted to hospital for acute liver injury within 30 days of receiving a prescription for 1 of 5 broad-spectrum antibiotic agents: moxifloxacin, levofloxacin, ciprofloxacin, cefuroxime axetil or clarithromycin. For each case, we selected up to 10 age- and sex-matched controls from among patients who had received a study antibiotic, but who were not admitted to hospital for acute liver injury. We calculated odds ratios (ORs) to determine the association between admission to hospital and previous exposure to an antibiotic agent, using clarithromycin as the reference.
resultsA total of 144 patients were admitted to hospital for acute liver injury within 30 days of receiving a prescription for one of the identified drugs. Of these patients, 88 (61.1%) died while in hospital. After multivariable adjustment, use of either moxifloxacin (adjusted OR 2.20, 95% confidence interval [CI] 1.21-3.98) or levofloxacin (adjusted OR 1.85, 95% CI 1.01-3.39) was associated with an increase in risk of acute liver injury relative to the use of clarithromycin. We saw no such risk associated with the use of either ciprofloxacin or cefuroxime axetil.
interpretationAmong older outpatients with no evidence of liver disease, moxifloxacin and levofloxacin were associated with an increased risk of acute liver injury relative to clarithromycin.
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