{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T10:02:31Z","timestamp":1785319351109,"version":"3.55.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Quinolone product information and avoidance lists continue to caution against use in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency despite limited comparative epidemiologic evidence. We evaluated whether oral quinolone dispensations were associated with haemolysis-related outcomes compared with an active antibiotic comparator.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a nationwide retrospective active-comparator cohort study using Clalit Health Services data from 2010 to 2023. Patients with at least one ICD-coded diagnosis of G6PD deficiency who received an outpatient oral quinolone or penicillin dispensation were included. The primary outcome was a haemolysis-related diagnosis code recorded within 30\u2005days. Jaundice and laboratory markers were secondary outcomes. Models were adjusted for age, sex and Charlson comorbidity index. Additional analyses evaluated patients aged 18\u2005years or younger, patients exposed to both antibiotic classes and individual quinolone agents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort included 465\u200a083 dispensations among 64\u200a861 patients (65\u200a906 quinolone and 399\u200a177 penicillin episodes). Haemolysis-related codes were recorded after 52 quinolone episodes (0.079%) and 198 penicillin episodes (0.050%); the adjusted odds ratio (aOR) was 1.29 [95% confidence interval (CI) 0.92\u20131.77; P\u200a=\u200a0.12]. Among patients aged 18\u2005years or younger, events occurred after 5\/8865 quinolone and 91\/160\u200a423 penicillin episodes (aOR 1.02, 95% CI 0.36\u20132.26, P\u200a=\u200a0.970). In the within-patient subcohort, episode-level event rates were 0.065% after quinolones and 0.061% after penicillins (aOR 0.95, 95% CI 0.65\u20131.37, P\u200a=\u200a0.785). Laboratory outcomes did not show a coherent pattern of increased haemolysis after quinolones.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large outpatient cohort, oral quinolone dispensations were not associated with a detectable major increase in coded haemolysis compared with penicillins. The findings do not exclude small risks or increased susceptibility in patients with severe G6PD deficiency, very young children, active infection-related oxidative stress or concurrent oxidant exposures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkag265","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T11:38:30Z","timestamp":1784979510000},"source":"Crossref","is-referenced-by-count":0,"title":["Quinolones and risk of haemolysis in patients with glucose-6-phosphate dehydrogenase deficiency: a nationwide retrospective active-comparator cohort study"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9681-8517","authenticated-orcid":false,"given":"Ophir","family":"Lavon","sequence":"first","affiliation":[{"name":"Clinical Pharmacology and Toxicology Unit, Carmel Medical Center , Mikhal St. 7, Haifa 3436212 ,","place":["Israel"]},{"name":"Rappaport Faculty of Medicine, Technion-Israel Institute of Technology , Haifa ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdallh","family":"Khazem","sequence":"additional","affiliation":[{"name":"Internal Medicine B, Carmel Medical Center , Haifa ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"2026072905272370800_dkag265-B1","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1056\/NEJM199101173240306","article-title":"Glucose-6-phosphate dehydrogenase deficiency","volume":"324","author":"Beutler","year":"1991","journal-title":"N Engl J Med"},{"key":"2026072905272370800_dkag265-B2","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/S0140-6736(08)60073-2","article-title":"Glucose-6-phosphate dehydrogenase deficiency","volume":"371","author":"Cappellini","year":"2008","journal-title":"Lancet"},{"key":"2026072905272370800_dkag265-B3","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1111\/bjh.12665","article-title":"G6PD deficiency: a classic example of pharmacogenetics with ongoing clinical implications","volume":"164","author":"Luzzatto","year":"2014","journal-title":"Br J Haematol"},{"key":"2026072905272370800_dkag265-B4","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.1182\/blood.2019000944","article-title":"Glucose-6-phosphate dehydrogenase deficiency","volume":"136","author":"Luzzatto","year":"2020","journal-title":"Blood"},{"key":"2026072905272370800_dkag265-B5","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1007\/s00277-010-0903-7","article-title":"Ciprofloxacin-induced acute haemolytic anaemia in a patient with glucose-6-phosphate dehydrogenase Mediterranean deficiency: a case report","volume":"89","author":"Sansone","year":"2010","journal-title":"Ann Hematol"},{"key":"2026072905272370800_dkag265-B6","doi-asserted-by":"publisher","first-page":"1010","DOI":"10.1345\/aph.1C525","article-title":"Levofloxacin-induced autoimmune hemolytic anemia","volume":"37","author":"Oh","year":"2003","journal-title":"Ann Pharmacother"},{"key":"2026072905272370800_dkag265-B7","doi-asserted-by":"publisher","first-page":"e136","DOI":"10.11622\/smedj.2014111","article-title":"Drug-induced immune haemolytic anaemia caused by levofloxacin","volume":"55","author":"Sukhal","year":"2014","journal-title":"Singapore Med J"},{"key":"2026072905272370800_dkag265-B8","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1016\/j.revmed.2008.07.007","article-title":"Ofloxacin is contraindicated in G6PD deficiency: is it evidence based?","volume":"30","author":"Carmoi","year":"2009","journal-title":"Rev Med Interne"},{"key":"2026072905272370800_dkag265-B9","doi-asserted-by":"publisher","first-page":"410","DOI":"10.4103\/ijn.IJN_138_20","article-title":"Ofloxacin-induced hemolysis in a G6PD-deficient patient: a rare cause of pigment nephropathy","volume":"31","author":"Parikh","year":"2021","journal-title":"Indian J Nephrol"},{"key":"2026072905272370800_dkag265-B10","doi-asserted-by":"publisher","first-page":"713","DOI":"10.2165\/11536520-000000000-00000","article-title":"Medications and glucose-6-phosphate dehydrogenase deficiency: an evidence-based review","volume":"33","author":"Youngster","year":"2010","journal-title":"Drug Saf"},{"key":"2026072905272370800_dkag265-B11","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1002\/cpt.2735","article-title":"Expanded clinical pharmacogenetics implementation consortium guideline for medication use in the context of G6PD genotype","volume":"113","author":"Gammal","year":"2023","journal-title":"Clin Pharmacol Ther"},{"key":"2026072905272370800_dkag265-B12","doi-asserted-by":"publisher","first-page":"1537","DOI":"10.1002\/cpt.3333","article-title":"Medications and acute hemolysis in G6PD-deficient patients: a real-world study","volume":"116","author":"Gronich","year":"2024","journal-title":"Clin Pharmacol Ther"},{"key":"2026072905272370800_dkag265-B13","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis"},{"key":"2026072905272370800_dkag265-B14","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1097\/MPH.0000000000002350","article-title":"Hemolysis after medication exposure in pediatric patients with G6PD deficiency","volume":"44","author":"Doshi","year":"2022","journal-title":"J Pediatr Hematol Oncol"},{"key":"2026072905272370800_dkag265-B15","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.31609","article-title":"Fava bean- versus non-fava bean-induced acute hemolytic crisis in children with glucose-6-phosphate dehydrogenase deficiency: a prospective comparative study","volume":"72","author":"Prashanth","year":"2025","journal-title":"Pediatr Blood Cancer"}],"container-title":["Journal of Antimicrobial Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/81\/8\/dkag265\/70333908\/dkag265.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/81\/8\/dkag265\/70333908\/dkag265.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T09:27:26Z","timestamp":1785317246000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jac\/article\/doi\/10.1093\/jac\/dkag265\/8746621"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":15,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,7,2]]}},"URL":"https:\/\/doi.org\/10.1093\/jac\/dkag265","relation":{},"ISSN":["0305-7453","1460-2091"],"issn-type":[{"value":"0305-7453","type":"print"},{"value":"1460-2091","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,8]]},"published":{"date-parts":[[2026,7,2]]},"article-number":"dkag265"}}