Table 3.
Standardized Incidence Rates and Incidence Rate Ratios of Liver Injury and Severe Liver Injurya
| Antimicrobial Exposure | Person-years (n=1,117,323) | Liver Injury | Severe Liver Injury | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Cases (n=607) | Incidence Rate | 95% CI | Incidence Rate Ratio | 95% CI | Cases (n=82) | Incidence Rate | 95% CI | Incidence Rate Ratio | 95% CI | ||
| Nonuse | 350,873 | 123 | 35.1 | 29.1–41.8 | REF | REF | 9 | 2.6 | 1.2–4.9 | REF | REF |
| Current single use | |||||||||||
| Amoxicillin | 44,555 | 23 | 51.0 | 32.2–77.0 | 1.45 | 0.93–2.28 | 4 | 9.4 | 2.5–24.3 | 3.67 | 1.12–12.00 |
| Amoxicillin-clavulanic acid | 35,529 | 30 | 86.0 | 57.8–123.1 | 2.45 | 1.64–3.67 | 5 | 13.1 | 4.2–31.2 | 5.10 | 1.70–15.31 |
| Cefuroxime | 21,456 | 14 | 70.3 | 37.3–120.2 | 2.01 | 1.13–3.56 | 2 | 11.5 | 1.2–41.0 | 4.48 | 0.93–21.63 |
| Clarithromycin | 25,593 | 16 | 64.4 | 36.3–105.3 | 1.84 | 1.08–3.13 | 1 | 6.8 | 0.2–30.8 | 2.67 | 0.34–21.06 |
| Doxycycline | 42,994 | 19 | 46.6 | 27.9–73.0 | 1.33 | 0.82–2.17 | 3 | 7.4 | 1.5–21.5 | 2.90 | 0.78–10.75 |
| Levofloxacin | 39,974 | 58 | 134.3 | 101.2–175.0 | 3.83 | 2.79–5.27 | 10 | 22.9 | 10.8–42.9 | 8.92 | 3.59–22.17 |
| Moxifloxacin | 24,901 | 30 | 116.4 | 78.4–166.7 | 3.32 | 2.22–4.96 | 3 | 10.6 | 2.2–32.1 | 4.12 | 1.11–15.22 |
| Telithromycin | 9175 | 3 | 26.6 | 5.5–83.1 | 0.76 | 0.24–2.38 | 1 | 8.9 | 0.2–56.2 | 3.45 | 0.44–27.25 |
| Recent single use | |||||||||||
| Amoxicillin | 87,527 | 27 | 29.0 | 19.0–42.6 | 0.83 | 0.54–1.26 | 3 | 3.5 | 0.7–10.4 | 1.36 | 0.37–5.08 |
| Amoxicillin-clavulanic acid | 66,390 | 26 | 42.4 | 27.6–62.1 | 1.21 | 0.79–1.85 | 2 | 3.0 | 0.3–11.2 | 1.18 | 0.25–5.68 |
| Cefuroxime | 38,510 | 12 | 28.9 | 14.8–51.5 | 0.82 | 0.45–1.50 | 1 | 2.1 | 0.1–14.1 | 0.83 | 0.11–6.57 |
| Clarithromycin | 48,097 | 12 | 25.1 | 12.9–43.9 | 0.72 | 0.39–1.30 | 1 | 2.8 | 0.1–13.7 | 1.09 | 0.14–8.59 |
| Doxycycline | 54,641 | 18 | 31.6 | 18.6–50.1 | 0.90 | 0.55–1.48 | 1 | 1.8 | 0.0–10.2 | 0.71 | 0.09–5.64 |
| Levofloxacin | 75,615 | 57 | 70.9 | 53.4–92.4 | 2.02 | 1.47–2.78 | 8 | 10.0 | 4.3–20.1 | 3.91 | 1.50–10.22 |
| Moxifloxacin | 46,732 | 25 | 52.6 | 34.0–77.8 | 1.50 | 0.97–2.31 | 5 | 10.0 | 3.2–23.7 | 3.91 | 1.31–11.70 |
| Telithromycin | 19,404 | 4 | 29.2 | 5.0–80.6 | 0.83 | 0.24–2.89 | 0 | 0.0 | 0.0–19.3 | 0.00 | 0.00 -NE |
| Current multiple use | 15,915 | 37 | 234.5 | 164.8–323.9 | 6.69 | 4.63–9.67 | 7 | 44.7 | 18.0–92.5 | 17.44 | 6.50–46.84 |
| Recent multiple use | 40,374 | 36 | 88.4 | 61.9–122.7 | 2.52 | 1.74–3.66 | 8 | 19.8 | 8.5–39.3 | 7.72 | 2.98–20.01 |
CI = confidence interval; NE = not estimable; REF = reference category.
a
Incidence rates are per 100,000 person-years. Standardization is by age and sex. Data are not shown for 29,068 person-years of exposure in which patients had current use of a single study antimicrobial and concurrent recent use of at least one other study antimicrobial, nor for 37 cases of liver injury (8 of which were severe liver injury) that occurred during this person-time.