Antibiotic exposure and drug-induced intracranial hypertension: a systematic review and meta-analysis
Abstract
Background/objectives: Drug-induced intracranial hypertension (DIH) is a rare condition that has been associated with several risk factors, including exposure to certain medications. Herein, we synthesised the literature-pooled quantitative risk of developing DIH with antibiotics use.
Subjects/methods: Medline, Embase, and Cochrane Library were searched (inception to June 2024). We included observational or randomised studies reporting the incidence of antibiotic-related DIH, or the comparative odds of DIH between antibiotic users and non-users. Risk of bias was assessed via the ROBINS-E tool. Non-pairwise and pairwise meta-analyses (with random effects) were conducted to determine the pooled incidence of antibiotic-related DIH and the comparative odds of DIH among antibiotic users and non-users, respectively.
Results: We identified 10 studies (all observational studies). Overall, tetracycline class antibiotics were significantly associated with DIH in both least- (3.96, 95%CI [1.33, 11.78], p = 0.013, I2: 98.7%) and most-adjusted (2.40, 95%CI [1.87, 3.06], p 2: 19.0%) analyses. Likewise, quinolone class antibiotics were significantly associated with DIH in both least- (2.54, 95%CI [1.57, 4.10], p 2: 78%) and most-adjusted (2.70, 95%CI [1.54, 4.75], p 2: 83.2%) analyses. Sensitivity analyses with the leave-one-out method or omission of "serious" risk of bias studies yielded consistent findings.
Conclusions: Despite unclear pathophysiology, low certainty evidence supports…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Ferulic acid regulates the AKT/GSK-3β/CRMP-2 signaling pathway in a middle cerebral artery occlusion animal model
- Novel Pharmacokinetic/Pharmacodynamic Parameters Quantify the Exposure–Effect Relationship of Levofloxacin against Fluoroquinolone-Resistant Escherichia coli
- Photochemical behavior of levofloxacin
- Correlation Between Dissolution Profiles of Salt-Form Drugs in Biorelevant Bicarbonate Buffer and Oral Drug Absorption: Importance of Dose/ Fluid Volume Ratio
- Evaluation of the synergistic potential and mechanisms of action for de novo designed cationic antimicrobial peptides
- Synthesis of [11C]levofloxacin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.