Category: Federal Forum Posters
Purpose: Respiratory fluoroquinolones (e.g., gemifloxacin, moxifloxacin, and levofloxacin) are recommended as first-line therapy for inpatient, non-intensive care unit (ICU) treatment of community-acquired pneumonia (CAP). Due to increasing reports of mental status changes associated with fluoroquinolone use, the FDA released a statement in July 2018 that fluoroquinolones may cause significant mental health adverse effects and required labeling changes making mental health adverse effects more prominent. Although several case reports and literature reviews have been published, there have been no retrospective cohort studies to our knowledge to determine the rates of mental health side effects from fluoroquinolone use at any one institution.
Methods: This study is pending Institutional Review Board approval. We will conduct a retrospective, cohort study of veterans 18 years of age and older admitted to the Oklahoma City Veterans Affairs Health Care System for treatment of CAP and prescribed either a respiratory fluoroquinolone (levofloxacin or moxifloxacin) or a beta-lactam plus azithromycin or doxycycline. The primary objective will be to determine the rate of mental status adverse effects associated with fluoroquinolone use versus combination therapy. Exclusion criteria will include veterans who are admitted to the ICU or inpatient psychiatric unit upon presentation, were initiated on antipsychotics within the past 12 months prior to admission, or have a diagnosis of acute alcohol use disorder (including alcohol withdrawal), substance-induced psychoses, dementia, or Alzheimer’s disease.
Results: not applicable
Conclusion: not applicable
Kearsten Westmoreland– PGY1 Pharmacy Resident, Oklahoma City Veterans Affairs Health Care System, Oklahoma City, OK