Baidu
map

美国FDA发布氟喹诺酮类药物引起主动脉破裂的新警告

2019-03-14 NEJM医学前沿 NEJM医学前沿

美国食品药品管理局(FDA)最近发布了关于主动脉破裂的新警告,这将对临床实践产生怎样的影响?氟喹诺酮类抗生素几十年来一直是抗菌治疗的主力。过去10年中,美国FDA已发布数条关于氟喹诺酮类药物可能引起致残性不良反应的警告,首先是肌腱病变和肌腱断裂。2018年7月,FDA加强了关于氟喹诺酮类药物可能对血糖稳态产生不良影响的警告,尤其是对于老年患者和服用口服降糖药的糖尿病患者。欧洲药品管理局(EMA)也

美国食品药品管理局(FDA)最近发布了关于主动脉破裂的新警告,这将对临床实践产生怎样的影响?

氟喹诺酮类抗生素几十年来一直是抗菌治疗的主力。过去10年中,美国FDA已发布数条关于氟喹诺酮类药物可能引起致残性不良反应的警告,首先是肌腱病变和肌腱断裂。2018年7月,FDA加强了关于氟喹诺酮类药物可能对血糖稳态产生不良影响的警告,尤其是对于老年患者和服用口服降糖药的糖尿病患者。欧洲药品管理局(EMA)也发布了关于氟喹诺酮类药物产生致残性和潜在永久性副作用的警告,声明在有其他选择或对使用抗生素有疑问的情况下,不应使用氟喹诺酮类药物。EMA特别提到了喹诺酮类药物用作复发性尿路感染患者的预防药物及用于预防旅行中的腹泻(https://viajwat.ch/2DC3NgD)。

如今,FDA在最近一次更新中强调了氟喹诺酮类药物的另一个不太常见但更严重的公认副作用——主动脉破裂和撕裂。氟喹诺酮类药物上调细胞基质金属蛋白酶,导致Ⅰ型和Ⅲ型胶原蛋白原纤维减少,而Ⅰ型和Ⅲ型胶原蛋白原纤维构成了跟腱和主动脉中的大部分胶原蛋白,这可能是这些不良事件的发生机制(J Orthop Res 2011; 29:67)。最近发表的研究表明,氟喹诺酮类药物使主动脉夹层和跟腱断裂风险有类似程度增加,达到对照组的约2.5~3倍(Pasternak et al., NEJM JW Gen Med May 1 2018 and BMJ 2018; 360:k678; Daneman et al., BMJ Open 2015; 5:e010077; JAMA Intern Med 2015; 175:1839; J Am Coll Cardiol 2018; 72:1369)。胶原蛋白也是构成玻璃体和维持视网膜附着的关键成分,但氟喹诺酮类药物是否介导视网膜脱离仍有争议。

FDA关于主动脉破裂的警告称,除非无其他治疗方案,否则医师不应给风险增加的患者开出氟喹诺酮类药物。警告中提到的有风险患者包括已知患主动脉瘤或其他动脉瘤、高血压或外周血管疾病的患者,老年人,以及影响胶原蛋白结构的罕见遗传病的患者(如马方综合征和埃勒斯-当洛综合征)。有趣的是,长期接受糖皮质激素治疗的患者发生肌腱断裂的风险增加,但在最近的警告中并未提及(Int J Antimicrob Agents 2010; 35:366)。

Pasternak等和Daneman等称,喹诺酮类药物导致的主动脉破裂或夹层风险约为每10,000个疗程1~2例。不幸的是,主动脉破裂风险不一定与长期治疗相关。在Pasternak的研究中,41%(26/64)的主动脉破裂发生在喹诺酮类药物治疗开始后10天内,55%发生在20天内。Daneman的研究表明,主动脉破裂时治疗时间的中位数为20天。因此,主动脉破裂风险不一定局限于接受长期治疗的患者。

FDA的新警告与美国传染病学会(Infectious Diseases Society of America )的社区获得性肺炎(CAP)治疗指南间接冲突,该指南建议将氟喹诺酮类药物用于有合并症的高危患者及有耐药性肺炎链球菌感染风险的患者(Clin Infect Dis 2007; 44 Suppl 2:S27)。根据FDA的警告,这些患者(经常是老年人且患高血压血管疾病)正是“医疗专业人员应避免开出氟喹诺酮类抗生素”的患者。肺炎链球菌对多西环素和大环内酯类药物的耐药率可能高达15%~30%,而对喹诺酮类药物的耐药率保持在1 %或以下。因此,如果对此类患者放弃使用喹诺酮类药物,抗菌剂用药不足的患者人数可能超过免于发生主动脉破裂的患者人数。例如,假设1/3的CAP病例是由肺炎链球菌引起,并且这些病例中有1/4对非喹诺酮类药物耐药,那么将有大约8%的CAP患者得不到充分治疗。

评论

评估氟喹诺酮类药物的利弊时,应常规考虑潜在的不良反应,包括主动脉破裂和夹层。例如,患重度社区获得性肺炎的老年轻度高血压患者使用氟喹诺酮类药物的利弊一定不同于已知患主动脉瘤或胶原蛋白紊乱,且有氟喹诺酮类药物边缘适应证的患者。然而,对于处在这两个极端之间的患者,要明确利弊并不容易。尤其是在急诊科和急救中心等繁忙的环境中,医师面临着快速决定抗菌治疗的压力,这可能导致其无法审慎考虑相对较小的药物不良反应风险。然而,医师给患者开出氟喹诺酮类药物时,应告知这些潜在副作用。长远来看,我们需要更多数据才能更好地确定氟喹诺酮类药物的利弊,但应尽快更新指南,以便更具体地建议临床医师何时开出这些药物。

参考文献:

U.S. Food and Drug Administration. Drug Safety Communication: FDA warns about increased risk of ruptures or tears in the aorta blood vessel with fluoroquinolone antibiotics in certain patients. December 20, 2018. (https://www.fda.gov/Drugs/DrugSafety/ucm628753.htm)

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1928451, encodeId=e55a192845174, content=<a href='/topic/show?id=3cf54018620' target=_blank style='color:#2F92EE;'>#喹诺酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40186, encryptionId=3cf54018620, topicName=喹诺酮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Wed May 15 22:01:00 CST 2019, time=2019-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2043103, encodeId=1ed2204310385, content=<a href='/topic/show?id=3f27639214c' target=_blank style='color:#2F92EE;'>#氟喹诺酮类药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63921, encryptionId=3f27639214c, topicName=氟喹诺酮类药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ffd5416, createdName=bettycmoon, createdTime=Sun Apr 07 11:01:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415481, encodeId=349714154811e, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sat Mar 16 11:01:00 CST 2019, time=2019-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1523109, encodeId=c2091523109ec, content=<a href='/topic/show?id=fe8663915a3' target=_blank style='color:#2F92EE;'>#氟喹诺酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63915, encryptionId=fe8663915a3, topicName=氟喹诺酮)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff0911497072, createdName=doctorzheng, createdTime=Sat Mar 16 11:01:00 CST 2019, time=2019-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551433, encodeId=c8a5155143356, content=<a href='/topic/show?id=5d84e9716c0' target=_blank style='color:#2F92EE;'>#美国FDA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79716, encryptionId=5d84e9716c0, topicName=美国FDA)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Mar 16 11:01:00 CST 2019, time=2019-03-16, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1928451, encodeId=e55a192845174, content=<a href='/topic/show?id=3cf54018620' target=_blank style='color:#2F92EE;'>#喹诺酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40186, encryptionId=3cf54018620, topicName=喹诺酮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Wed May 15 22:01:00 CST 2019, time=2019-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2043103, encodeId=1ed2204310385, content=<a href='/topic/show?id=3f27639214c' target=_blank style='color:#2F92EE;'>#氟喹诺酮类药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63921, encryptionId=3f27639214c, topicName=氟喹诺酮类药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ffd5416, createdName=bettycmoon, createdTime=Sun Apr 07 11:01:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415481, encodeId=349714154811e, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sat Mar 16 11:01:00 CST 2019, time=2019-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1523109, encodeId=c2091523109ec, content=<a href='/topic/show?id=fe8663915a3' target=_blank style='color:#2F92EE;'>#氟喹诺酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63915, encryptionId=fe8663915a3, topicName=氟喹诺酮)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff0911497072, createdName=doctorzheng, createdTime=Sat Mar 16 11:01:00 CST 2019, time=2019-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551433, encodeId=c8a5155143356, content=<a href='/topic/show?id=5d84e9716c0' target=_blank style='color:#2F92EE;'>#美国FDA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79716, encryptionId=5d84e9716c0, topicName=美国FDA)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Mar 16 11:01:00 CST 2019, time=2019-03-16, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1928451, encodeId=e55a192845174, content=<a href='/topic/show?id=3cf54018620' target=_blank style='color:#2F92EE;'>#喹诺酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40186, encryptionId=3cf54018620, topicName=喹诺酮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Wed May 15 22:01:00 CST 2019, time=2019-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2043103, encodeId=1ed2204310385, content=<a href='/topic/show?id=3f27639214c' target=_blank style='color:#2F92EE;'>#氟喹诺酮类药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63921, encryptionId=3f27639214c, topicName=氟喹诺酮类药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ffd5416, createdName=bettycmoon, createdTime=Sun Apr 07 11:01:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415481, encodeId=349714154811e, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sat Mar 16 11:01:00 CST 2019, time=2019-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1523109, encodeId=c2091523109ec, content=<a href='/topic/show?id=fe8663915a3' target=_blank style='color:#2F92EE;'>#氟喹诺酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63915, encryptionId=fe8663915a3, topicName=氟喹诺酮)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff0911497072, createdName=doctorzheng, createdTime=Sat Mar 16 11:01:00 CST 2019, time=2019-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551433, encodeId=c8a5155143356, content=<a href='/topic/show?id=5d84e9716c0' target=_blank style='color:#2F92EE;'>#美国FDA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79716, encryptionId=5d84e9716c0, topicName=美国FDA)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Mar 16 11:01:00 CST 2019, time=2019-03-16, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1928451, encodeId=e55a192845174, content=<a href='/topic/show?id=3cf54018620' target=_blank style='color:#2F92EE;'>#喹诺酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40186, encryptionId=3cf54018620, topicName=喹诺酮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Wed May 15 22:01:00 CST 2019, time=2019-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2043103, encodeId=1ed2204310385, content=<a href='/topic/show?id=3f27639214c' target=_blank style='color:#2F92EE;'>#氟喹诺酮类药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63921, encryptionId=3f27639214c, topicName=氟喹诺酮类药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ffd5416, createdName=bettycmoon, createdTime=Sun Apr 07 11:01:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415481, encodeId=349714154811e, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sat Mar 16 11:01:00 CST 2019, time=2019-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1523109, encodeId=c2091523109ec, content=<a href='/topic/show?id=fe8663915a3' target=_blank style='color:#2F92EE;'>#氟喹诺酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63915, encryptionId=fe8663915a3, topicName=氟喹诺酮)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff0911497072, createdName=doctorzheng, createdTime=Sat Mar 16 11:01:00 CST 2019, time=2019-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551433, encodeId=c8a5155143356, content=<a href='/topic/show?id=5d84e9716c0' target=_blank style='color:#2F92EE;'>#美国FDA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79716, encryptionId=5d84e9716c0, topicName=美国FDA)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Mar 16 11:01:00 CST 2019, time=2019-03-16, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1928451, encodeId=e55a192845174, content=<a href='/topic/show?id=3cf54018620' target=_blank style='color:#2F92EE;'>#喹诺酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40186, encryptionId=3cf54018620, topicName=喹诺酮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Wed May 15 22:01:00 CST 2019, time=2019-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2043103, encodeId=1ed2204310385, content=<a href='/topic/show?id=3f27639214c' target=_blank style='color:#2F92EE;'>#氟喹诺酮类药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63921, encryptionId=3f27639214c, topicName=氟喹诺酮类药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ffd5416, createdName=bettycmoon, createdTime=Sun Apr 07 11:01:00 CST 2019, time=2019-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415481, encodeId=349714154811e, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sat Mar 16 11:01:00 CST 2019, time=2019-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1523109, encodeId=c2091523109ec, content=<a href='/topic/show?id=fe8663915a3' target=_blank style='color:#2F92EE;'>#氟喹诺酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63915, encryptionId=fe8663915a3, topicName=氟喹诺酮)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff0911497072, createdName=doctorzheng, createdTime=Sat Mar 16 11:01:00 CST 2019, time=2019-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551433, encodeId=c8a5155143356, content=<a href='/topic/show?id=5d84e9716c0' target=_blank style='color:#2F92EE;'>#美国FDA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79716, encryptionId=5d84e9716c0, topicName=美国FDA)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Mar 16 11:01:00 CST 2019, time=2019-03-16, status=1, ipAttribution=)]

相关资讯

EMA:潜在的永久性副作用导致喹诺酮和氟喹诺酮抗生素的停用或限制

EMA已经审查了口服、注射或吸入给药的喹诺酮和氟喹诺酮类抗生素的潜在永久性副作用。该评论纳入了2018年6月EMA公开听证会上关于氟喹诺酮和喹诺酮类抗生素的患者,医疗保健专业人员和学者的观点。

BMJ:氟喹诺酮类药物增加患者主动脉瘤或夹层风险

研究认为口服氟喹诺酮类药物导致患者主动脉瘤或夹层风险增加

PLOS ONE:口服氟喹诺酮类药物增加视网膜脱离?

为了调查口服氟喹诺酮类药物(FQ)与孔源性视网膜脱离(RRD)的风险之间的关系,研究人员在韩国开展了一项全国性的基于人群的研究,控制与时间相关的偏倚。

美国警示氟喹诺酮抗生素的主动脉瘤破裂或夹层风险

2018年12月20日,美国食品药品监督管理局(FDA)评估发现氟喹诺酮抗生素能增加罕见且严重的主动脉瘤破裂或夹层风险的发生。主动脉瘤破裂或主动脉撕裂(也称主动脉壁夹层),可导致出血危险甚至死亡,全身使用(口服、注射)氟喹诺酮抗生素可发生此风险。氟喹诺酮抗生素批准用于治疗某些细菌感染,并已上市使用了30余年。氟喹诺酮抗生素通过杀菌或抑制致病菌生长发挥疗效,如果不进行治疗,一些感染可能扩散并导致严重

JACC:口服氟喹诺酮会增加主动脉夹层风险

既往研究显示氟喹诺酮治疗可能会增加胶原疾病、主动脉瘤与夹层(AA/AD)的发病风险。本研究的目的旨在通过一个大型国家行政数据库的案例交叉分析来评估这种相关性。本研究共纳入了2001-2011年1213例住院的AA/AD病人,分析结果发现,暴露于氟喹诺酮的概率在危险期(AA/AD事件发生前60天)比对照期(AA/AD事件发生前60-180天中的任意60天)要更高(1.6% vs. 0.6%; [OR

FDA全新警告:氟喹诺酮增加总动脉夹层风险,这些人不要再用!

2018年12月20日,美国食品药品监督管理局(FDA)发布最新警告信息

Baidu
map
Baidu
map
Baidu
map