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Fluoroquinolone Antibiotics May Double Risk of Kidney Disease

Report underscores importance of vigilant prescribing (June 3)

The use of fluoroquinolone antibiotics may be associated with a doubling of the risk of acute kidney injury, according to a study published in the Canadian Medical Association Journal.

Fluoroquinolones — including ciprofloxacin, levofloxacin, and moxifloxacin — are common broad-spectrum antibiotics most often used to treat respiratory and urogenital infections. Case reports have indicated acute kidney injury with use, and prescription labels carry a warning of kidney failure. However, when oral fluoroquinolones are prescribed in clinical practice, kidney injury usually is not considered.

Researchers in the U.S. and Canada conducted a case-control analysis to determine the risk of acute kidney injury with the use of oral fluoroquinolones in men aged 40 to 85 years enrolled in the United States IMS LifeLink Health Plan Claims Database between 2001 and 2011. The investigators identified 1,292 cases and 12,651 matched controls.

Current use of fluoroquinolones had a 2.18-fold higher adjusted relative risk of acute kidney injury compared with no use. Moreover, the dual use of fluoroquinolones and renin–angiotensin blockers had a relative risk of 4.46 for acute kidney injury.

The absolute increase in acute kidney injury was 6.5 events per 10,000 person–years with current fluoroquinolone use. The use of amoxicillin or azithromycin was not associated with acute kidney injury.

Source: CMAJ; June 3, 2013.

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