Cohort studycited by the Tayebat archiveabstract only checked A-ABX-16 standard review
Fluoroquinolones and aortic aneurysm (Sweden)
Fluoroquinolone use and risk of aortic aneurysm and dissection: nationwide cohort study.
Overview
Pasternak B et al.. BMJ 2018 · PMID 29519881 · DOI 10.1136/bmj.k678
About 82 extra cases per million treatment courses compared with amoxicillin.
Does the study support the specific claim? Yes · Methodological quality: high
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Link.
- How was the study done?
Cohort.
- How many people, animals or samples were studied?
720,176 episodes.
- What was actually found?
Higher risk.
- How large was the observed effect?
HR 1.66; +82/million.
- What do the results mean in everyday life?
Rare.
- What are the study's limitations?
Observational.
- What does it say about Elawady's specific claim?
Supports.
- Do the results apply to Germany and Europe?
High.
Scientific in-depth review
1. Full reference
- Authors
- Pasternak B, Inghammar M, Svanström H
- Journal
- BMJ
- Year
- 2018
- Identifier
- PMID 29519881 DOI 10.1136/bmj.k678 · PMC5842359
- Verification
- verified – PubMed E-utilities efetch, 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
2. Research question
Oral FQ and aortic aneurysm/dissection
3. Study design and population
- Study design
- Cohort study – Nationwide propensity-matched cohort (Sweden)
- Population
Treatment episodes
- Country
Sweden
- Period
2006-2013
- Sample size
360,088 FQ vs 360,088 amoxicillin episodes
4. Methods and endpoints
- Exposure / intervention
FQ
- Comparator
Amoxicillin
- Endpoints
AA/AD within 60 days
- Statistical methods
Cox
5. Actual results
- Results
1.2 vs 0.7 per 1000 PY; HR 1.66 (1.12-2.46); 82 (15-181) extra cases per million episodes; aneurysm HR 1.90; dissection HR 0.93 (ns).
- Absolute risks
82 additional cases per 1 million treatment episodes by 60 days.
- Authors' conclusion
Association largely driven by aortic aneurysm.
6. Strengths
- Active comparator
- Absolute risk
7. Weaknesses
- Observational
8. Risk of bias
- Orienting tool
- ROBINS-I
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- low
9. Assessment of the statistical interpretation
10. Relevance to the specific claim
11. Independent contrary findings
12. Transferability to Germany and Europe
High.
13. Overall methodological judgement
High-quality signal.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | high |
| Risk of bias | low |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
15. Linked fact checks
Use by the Tayebat archive
Note: according to the archive, the studies were compiled by the archive operators. Whether Dr. Elawady himself cited this study is not established.
- What the archive says about the study
Bibliography only.
- A. What was actually studied?
Aortic events.
- B. What did the authors find?
Small absolute increase.
- C. What conclusions do the authors themselves draw?
As found.
- D. What does the archive derive from it?
Harm.
- E. Is this derivation scientifically justified?
Justified.
- Adequacy of the interpretation (by the archive)
- not applicable