Aortic, Mitral Regurgitation Risk Up With Fluoroquinolone Use

The risk for aortic and mitral regurgitation is increased with current and recent fluoroquinolone (FQ) use.

Mahyar Etminan, Pharm.D., from the University of British Columbia in Vancouver, Canada, and colleagues conducted a disproportionality analysis and nested case-control study to examine whether FQs increase the risk for aortic and mitral regurgitation. Rate ratios were compared for current and recent FQ use and amoxicillin and azithromycin use.

In the disproportionality analysis, the researchers found 102 reported events of FQ valvular regurgitation and 6,099 reports with other drugs during 2004 to 2018, with a reported odds ratio of 1.45 (95 percent confidence interval, 1.20 to 1.77). In the case-control study, 12,505 cases and 125,020 controls were identified. Compared with amoxicillin and azithromycin users, the adjusted rate ratios for current FQ users were 2.40 (95 percent confidence interval, 1.82 to 3.16) and 1.75 (95 percent confidence interval, 1.34 to 2.29), respectively. For recent and past FQ users (within 31 to 60 days and within 61 to 365 days prior to the event days, respectively), the adjusted rate ratios were 1.47 (95 percent confidence interval, 1.03 to 2.09) and 1.06 (95 percent confidence interval, 0.91 to 1.21), respectively.

"It might be prudent to consider antibiotics that are chemically distinct to FQs in patients with a previous history of valvular regurgitation who require antibacterial therapy," the authors write. "Future studies are urgently required to confirm or refute these findings."

This study was published in the Sept. 17 issue of the Journal of the American College of Cardiology.

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