Risk of Aortic Aneurysm or Aortic Dissection with Infections vs Fluoroquinolones

MedicalResearch.com Interview with:
Yaa-Hui Dong PhD
Faculty of Pharmacy
National Yang-Ming University
Taipei, Taiwan

MedicalResearch.com: What is the background for this study?

Response: Previous observational studies found that fluoroquinolones may be associated with more than 2-fold increased risk of aortic aneurysm or aortic dissection (AA/AD). However, these studies might not well address the influence of concurrent infection, which is also a suggested risk factor for AA. Moreover, most of these studies compared fluoroquinolone use versus no fluoroquinolone use, which might overestimate the risk with fluoroquinolones as patients on fluoroquinolones may have more severe infection versus those not on fluoroquinolones.

MedicalResearch.com: What are the main findings?

Response: Our nationwide nested case-control study suggested that infection was associated with a 1.73-fold greater risk for developing AA/AD. Instead, use of fluoroquinolones was not associated with an elevated risk of AA/AD versus use of antibiotics with similar indications, including extended-spectrum cephalosporins (OR, 1.01; 95% CI, 0.82-1.24) and amoxicillin/clavulanate or ampicillin/sulbactam (OR, 0.88; 0.70-1.11), after meticulously accounting for concurrent infection.

MedicalResearch.com: What should readers take away from your report?

Response: Infection per se does have a harmful effect of AA/AD. However, fluoroquinolnes do not have a higher risk of AA/AD as compared to antibiotics with similar indications. Worries of AA/AD should not prevent patients with clinical indication from necessary treatment with fluoroquinolones.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: The present study analyzed a Taiwanese nationwide health insurance claims database. We are hopeful that additional studies using different data source or including important clinical information such as microbiology testing results and laboratory data to confirm our findings. 


Dong Y, Chang C, Wang J, Wu L, Lin J, Toh S. Association of Infections and Use of Fluoroquinolones With the Risk of Aortic Aneurysm or Aortic Dissection. JAMA Intern Med. Published online September 08, 2020. doi:10.1001/jamainternmed.2020.4192

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Last Updated on September 8, 2020 by Marie Benz MD FAAD