ArticleBMJ open2015
Fluoroquinolones and collagen associated severe adverse events: a longitudinal cohort study.
Article in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 89 papers, 8 of them syntheses that pooled it.
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Who cites it
89 citing papers in PubMed, 8 syntheses or guidelines pooled it, 222 citations in OpenAlex.
- Effects of Fluoroquinolones on Aortic Aneurysm or Dissection Processes: A Systematic Review and Meta-Analysis.Reviews in cardiovascular medicine · 2026Pooled it
- Do fluoroquinolones increase aortic aneurysm or dissection incidence and mortality? A systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2022Pooled it
- The association between fluoroquinolones and aortic dissection and aortic aneurysms: a systematic review and meta-analysis.Scientific reports · 2021Pooled it
- Assessment of the risk of musculoskeletal adverse events associated with fluoroquinolone use in children: A meta-analysis.Medicine · 2020Pooled it
- Relationship between fluoroquinolones and the risk of aortic diseases: a meta-analysis of observational studies.BMC cardiovascular disorders · 2020Pooled it
- Fluoroquinolones and the risk of tendon injury: a systematic review and meta-analysis.European journal of clinical pharmacology · 2019Pooled it
- Fluoroquinolone Use and the Risk of Collagen-Associated Adverse Events: A Systematic Review and Meta-Analysis.Drug safety · 2019Pooled it
- Fluoroquinolones and the Risk of Aortic Aneurysm or Aortic Dissection: A Systematic Review and Meta-Analysis.Cardiovascular & hematological agents in medicinal chemistry · 2019Pooled it
- Rare Complications in Crohn's Disease: Diagnostic and Therapeutic Challenge of Dermal Abscesses Caused by Nontuberculous Mycobacteria Following Infliximab Therapy, and Fluoroquinolone-Related Achilles Tendon Rupture.The American journal of case reports · 2026Article
- Effects of fluoroquinolone antibiotics on extracellular matrix-related phenotypes in tendon cells.Scientific reports · 2026Article
- Oral fluoroquinolone use and the risk of aortic and mitral valve regurgitation: a nationwide cohort study.BMJ open · 2026Article
- Translational Model to Predict Lung and Prostate Distribution of Levofloxacin in Humans.Pharmaceutics · 2026Article
- Fluoroquinolone prescribing to older adults following FDA boxed warnings: a comparative analysis.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Impact of community pharmacist antibiotic prescribing for minor ailments: an interrupted time series analysis.BMJ open · 2025Article
- Fluoroquinolone use and aortic aneurysm or dissection: a German cohort study based on nationwide SHI-physicians outpatient claims data confirms increased risk.BMC cardiovascular disorders · 2025Article
- Association between fluoroquinolones and retinal detachment: insights from a large German health claims-based cohort study.BMC ophthalmology · 2025Article
- Fluoroquinolones and the risk of aortic aneurysm or dissection: A population-based propensity score-matched German cohort study.Pharmacotherapy · 2025Article
- Mitochondrial Dysfunction: A New Hallmark in Hereditable Thoracic Aortic Aneurysm Development.Cells · 2025Review
- Investigating long-term risk of aortic aneurysm and dissection from fluoroquinolones and the key contributing factors using machine learning methods.Scientific reports · 2025Article
- Article
29 more citing papers are in PubMed but not listed here.
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesFluoroquinolone-associated tendon ruptures are a recognised complication, but other severe collagen-associated adverse events may also be possible. Our objectives were to confirm the association of fluoroquinolones and tendon rupture, to clarify the potential association of fluoroquinolones and retinal detachment, and to test for a potentially lethal association between fluoroquinolones and aortic aneurysms.
settingPopulation-based longitudinal cohort study in Ontario, Canada.
participantsOlder adults turning 65 years between April 1 1997 and March 31 2012 were followed until primary outcome, death, or end of follow-up (March 31 2014). Fluoroquinolone prescriptions were measured as a time-varying covariate, with patients considered at risk during and for 30 days following a treatment course. PRIMARY OUTCOME MEASURES: Severe collagen-associated adverse events defined as tendon ruptures, retinal detachments and aortic aneurysms diagnosed in hospital and emergency departments.
resultsAmong the 1,744,360 eligible patients, 657,950 (38%) received at least one fluoroquinolone during follow-up, amounting to 22,380,515 days of treatment. The patients experienced 37,338 (2.1%) tendon ruptures, 3246 (0.2%) retinal detachments, and 18,391 (1.1%) aortic aneurysms. Severe collagen-associated adverse events were more common during fluoroquinolone treatment than control periods, including tendon ruptures (0.82 vs 0.26/100-person years, p<0.001), retinal detachments (0.03 vs 0.02/100-person-years, p=0.003) and aortic aneurysms (0.35 vs 0.13/100-person-years, p<0.001). Current fluoroquinolones were associated with an increased hazard of tendon rupture (HR 3.13, 95% CI 2.98 to 3.28; adjusted HR 2.40, 95% CI 2.24 to 2.57) and an increased hazard of aortic aneurysms (HR 2.72, 95% CI 2.53 to 2.93; adjusted HR2.24, 95% CI 2.02 to 2.49) that were substantially greater in magnitude than the association of these outcomes with amoxicillin. The hazard of retinal detachment was marginal (HR 1.28, 95% CI 0.99 to 1.65; adjusted HR 1.47, 95% CI 1.08 to 2.00) and not greater in magnitude than that observed with amoxicillin.
conclusionsFluoroquinolones are associated with subsequent tendon ruptures and may also contribute to aortic aneurysms.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.