Introduction Fluoroquinolones can cause severe collagen-associated adverse effects, potentially impacting the pulmonary connective tissue. We investigated the association between fluoroquinolones and spontaneous pneumothorax. Methods A case–time–control study was performed using the nationwide French reimbursement healthcare system database (SNDS). Cases were adults ≥18 years admitted for spontaneous pneumothorax between 2017 and 2022. For each case, fluoroquinolone use was compared between the risk period immediately preceding the admission date (days −30 to −1), and three earlier reference periods (days −180 to −151, −150 to −121, −120 to −91), adjusting for time-varying confounders. OR estimates were corrected for potential exposure-trend bias using a reference group without the event (matched on age, sex, chronic obstructive pulmonary disease history, calendar time). Amoxicillin use was studied similarly to control for indication bias. Results Of the 246 pneumothorax cases exposed to fluoroquinolones (63.8% men; mean age, 43.0±18.4 years), 63 were exposed in the 30-day risk period preceding pneumothorax and 128 in the reference periods. Of the 3316 amoxicillin cases (72.9% men; mean age, 39.4±17.6 years), 1210 were exposed in the 30-day risk period and 1603 in the reference ones. OR adjusted for exposure-trend and covariates was 1.59 (95% CI 1.14 to 2.22) for fluoroquinolones and 2.25 (2.07 to 2.45) for amoxicillin. Conclusion An increased risk of spontaneous pneumothorax was associated with both fluoroquinolone and amoxicillin use, with an even higher association for amoxicillin. This strongly suggests the role of the underlying infections rather than a causal effect of the individual antibiotics and can be considered reassuring regarding a potential lung connective toxicity of fluoroquinolones. No data are available. No additional data available by author (French law to access SNDS www.health-data-hub.fr).

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氟喹诺酮类药物与自发性气胸风险的相关性：全国病例-时间-对照研究


简介 氟喹诺酮类药物可引起严重的胶原蛋白相关不良反应，可能影响肺结缔组织。我们调查了氟喹诺酮类药物与自发性气胸之间的关联。方法 使用全国性的法国报销医疗保健系统数据库 （SNDS） 进行病例时间对照研究。病例为 2017 年至 2022 年间因自发性气胸入院的 ≥18 岁成年人。对于每种病例，比较了入院日期前的风险期 （-30 至 -1 天） 和三个早期参考期 （-180 至 -151 天、-150 至 -121 天、-120 至 -91 天） 之间的氟喹诺酮类药物使用情况，并调整了时变混杂因素。使用没有事件的参考组（匹配年龄、性别、慢性阻塞性肺疾病史、日历时间）校正潜在的暴露-趋势偏倚的 OR 估计值。阿莫西林的使用研究与对照的适应症偏倚类似。结果 在暴露于氟喹诺酮类药物的 246 例气胸病例中 （63.8% 为男性;平均年龄 43.0±18.4 岁），63 例在气胸前的 30 天风险期内暴露，128 例在参考期暴露。在 3316 例阿莫西林病例（72.9% 为男性;平均年龄为 39.4±17.6 岁）中，1210 例在 30 天风险期内暴露，1603 例在参考期暴露。根据暴露趋势和协变量调整后的氟喹诺酮类药物的 OR 为 1.59 （95% CI 1.14 至 2.22），阿莫西林为 2.25 （2.07 至 2.45）。结论 自发性气胸风险增加与氟喹诺酮类和阿莫西林的使用相关，阿莫西林的相关性更高。 这强烈表明潜在感染的作用，而不是单个抗生素的因果效应，并且可以认为氟喹诺酮类药物的潜在肺结缔毒性令人放心。没有可用的数据。作者没有其他数据（访问 SNDS www.health-data-hub.fr 的法国法律）。