Objective To investigate whether oral fluoroquinolone use is associated with an increased risk of aortic aneurysm or dissection.
Design Nationwide historical cohort study using linked register data on patient characteristics, filled prescriptions, and cases of aortic aneurysm or dissection.
Setting Sweden, July 2006 to December 2013.
Participants 360 088 treatment episodes of fluoroquinolone use (78%ciprofloxacin) and propensity score matched comparator episodes of amoxicillin use (n=360 088).
Main outcome measures Cox regression was used to estimate hazard ratios for a first diagnosis of aortic aneurysm or dissection, defined as admission to hospital or emergency department for, or death due to, aortic aneurysm or dissection, within 60 days from start of treatment.
Results Within the 60 day risk period, the rate of aortic aneurysm or dissection was 1.2 cases per 1000 person years among fluoroquinolone users and 0.7 cases per 1000 person years among amoxicillin users. Fluoroquinolone use was associated with an increased risk of aortic aneurysm or dissection (hazard ratio 1.66 (95% confidence interval 1.12 to 2.46)), with an estimated absolute difference of 82 (95% confidence interval 15 to 181) cases of aortic aneurysm or dissection by 60 days per 1 million treatment episodes. In a secondary analysis, the hazard ratio for the association with fluoroquinolone use was 1.90 (1.22 to 2.96) for aortic aneurysm and 0.93 (0.38 to 2.29) for aortic dissection.
Conclusions In a propensity score matched cohort, fluoroquinolone use was associated with an increased risk of aortic aneurysm or dissection. This association appeared to be largely driven by aortic aneurysm.

中文翻译：

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氟喹诺酮类药物的使用以及主动脉瘤和夹层的风险：全国队列研究

目的探讨口服氟喹诺酮是否与增加主动脉瘤或夹层动脉瘤的风险有关。使用有关患者特征，填写好的处方以及主动脉瘤或夹层病例的相关注册数据，
设计全国性的历史队列研究。于2006年7月至2013年12月在瑞典
设定。
参加者使用氟喹诺酮360 088次治疗发作（78％环丙沙星）和倾向评分与使用阿莫西林的比较者发作相符（n = 360 088）。
主要结局指标使用Cox回归来评估主动脉瘤或夹层的首次诊断的危险比，主动脉瘤或夹层的定义是在治疗开始后60天内因主动脉瘤或夹层而入院或因主动脉瘤或夹层而死亡。
结果在60天的危险期内，氟喹诺酮使用者的主动脉瘤或夹层发生率为每1000人年1.2例，阿莫西林使用者为每1000人年0.7例。使用氟喹诺酮会增加主动脉瘤或夹层的风险（危险比1.66（95％置信区间1.12至2.46）），估计绝对差值为82（95％置信区间15至181）的主动脉瘤或夹层病例。每100万次治疗发作减少60天。在次要分析中，与氟喹诺酮类药物联合使用的风险比对于主动脉瘤为1.90（1.22至2.96），对于主动脉夹层为0.93（0.38至2.29）。
结论在倾向评分匹配的队列中，使用氟喹诺酮会增加主动脉瘤或夹层动脉瘤的风险。这种联系似乎主要是由主动脉瘤驱动的。