{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T23:03:43Z","timestamp":1792451023655,"version":"4.5.0"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To examine the association between newly prescribed fluoroquinolones (FQ) and the occurrence of polyneuropathy and certain neuropsychiatric events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>German statutory health insurance\u2010based cohort study (2013\u20132019) of patients exposed to FQ compared to different reference antibiotics. Patients with an incident antibiotic prescription were followed up for 365\u2009days after initial dispensing. Outcomes were defined by incident diagnoses of polyneuropathy\/other peripheral nervous system\u2010related diseases (PNS), depression\/other affective disorders (DEP), mood\u2010related symptoms (MOOD), somnolence\/stupor\/coma (SSC), and consciousness\u2010related symptoms (CONSCIOUS). Piece\u2010wise exponential additive mixed models adjusted for person\u2010time, age, comorbidities, year, and quarter of cohort entry were applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The outcome\u2010specific cohorts included 10.7\u201314.3 million antibiotic episodes of which 1.7% had incident PNS, 4.8% DEP, 1.5% MOOD, 0.6% SSC, 0.8% CONSCIOUS. Relative risks for these outcomes ranged from 1.04 to 1.10 for FQ versus reference antibiotics. Stratified by gender and age groups, relative risk for PNS was high in \u2264\u200939\u2010year\u2010old males (aHR\u2009=\u20091.31 [95% 1.19; 1.45]), for MOOD and CONSCIOUS in 40\u201369\u2010year\u2010old females (aHR\u2009=\u20091.12 [1.08; 1.15], aHR\u2009=\u20091.14 [1.09; 1.19]) for DEP in \u2265\u200970\u2010year\u2010old males (aHR\u2009=\u20091.16 [1.14; 1.19]), whereas relative risk for SSC was high in \u2264\u200939\u2010year\u2010old females (aHR\u2009=\u20091.24 [1.10; 1.40]). FQ\u2010associated PNS was mainly comprised of drug\u2010induced polyneuropathy (aHR\u2009=\u20091.68 [1.58; 1.79]). Relative risks for each endpoint varied by choice of active comparator.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>FQ episodes were associated with an increased risk for neurological and neuropsychiatric events, especially within the first 92\u2009days after initial dispensing. Risk estimates vary by age and gender subgroups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70585","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T05:51:24Z","timestamp":1774504284000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Fluoroquinolone\u2010Associated Peripheral and Central Nervous System\u2010Related Disorders: A Large German Claims\u2010Based Cohort Study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9630-6239","authenticated-orcid":false,"given":"Julia","family":"Wicherski","sequence":"first","affiliation":[{"name":"Federal Institute for Drugs and Medical Devices (BfArM), Research Division, Pharmacoepidemiology  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Peltner","sequence":"additional","affiliation":[{"name":"German Center for Neurodegenerative Diseases (DZNE), Pharmacoepidemiology in Neurodegenerative Disorders  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Becker","sequence":"additional","affiliation":[{"name":"Federal Institute for Drugs and Medical Devices (BfArM), Research Division, Pharmacoepidemiology  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Sch\u00fcssel","sequence":"additional","affiliation":[{"name":"Research Institute of AOK (WIdO)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Br\u00fcckner","sequence":"additional","affiliation":[{"name":"Research Institute of AOK (WIdO)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Schlotmann","sequence":"additional","affiliation":[{"name":"Research Institute of AOK (WIdO)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmut","family":"Schr\u00f6der","sequence":"additional","affiliation":[{"name":"Research Institute of AOK (WIdO)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winfried V.","family":"Kern","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine II University of Freiburg Faculty of Medicine and Medical Centre  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4828-6058","authenticated-orcid":false,"given":"Britta","family":"Haenisch","sequence":"additional","affiliation":[{"name":"Federal Institute for Drugs and Medical Devices (BfArM), Research Division, Pharmacoepidemiology  Bonn Germany"},{"name":"German Center for Neurodegenerative Diseases (DZNE), Pharmacoepidemiology in Neurodegenerative Disorders  Bonn Germany"},{"name":"Center for Translational Medicine University of Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"European Medicines Agency \u201cDisabling and Potentially Permanent Side Effects Lead to Suspension or Restrictions of Quinolone and Fluoroquinolone Antibiotics \u201d2019 Report No.: EMA\/175398\/2019."},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-023-01286-4"},{"key":"e_1_2_13_4_1","unstructured":"Medicines and Healthcare products Regulatory Agency \u201cFluoroquinolone Antibiotics: Reminder of The Risk of Disabling and Potentially Long\u2010Lasting or Irreversible Side Effects 2023 \u201dhttps:\/\/www.gov.uk\/drug\u2010safety\u2010update\/fluoroquinolone\u2010antibiotics\u2010reminder\u2010of\u2010the\u2010risk\u2010of\u2010disabling\u2010and\u2010potentially\u2010long\u2010lasting\u2010or\u2010irreversible\u2010side\u2010effects#disabling\u2010and\u2010potentially\u2010long\u2010lasting\u2010or\u2010irreversible\u2010side\u2010effects."},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5219"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40261-017-0498-z"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/15376516.2015.1026008"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0014-2999(03)01316-5"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3006055"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.12788\/jcso.0167"},{"key":"e_1_2_13_11_1","unstructured":"Bundesinstitut f\u00fcr Arzneimittel und Medizinprodukte (BfArM) \u201cClassifications 2024 \u201dhttps:\/\/www.bfarm.de\/EN\/Code\u2010systems\/Classifications\/_node.html."},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.7326\/M18-3079"},{"key":"e_1_2_13_13_1","unstructured":"Statistisches Bundesamt (DeStatis) \u201cBev\u00f6lkerung Zum Stichtag 31.12. Des Jeweiligen Jahres. Gliederungsmerkmale: Jahre Region Alter Geschlecht Nationalit\u00e4t (Grundlage Zensus 2011) 2025 \u201dhttps:\/\/www.gbe\u2010bund.de\/gbe\/isgbe.suche?p_uid=gast&p_aid=12375960&p_knoten=VR&p_sprache=D&p_adv_search=&p_methode=2&p_volltext=1&p_synonyme=1&p_soundex=&p_suchstring=Bev%C3%B6lkerung%20zum%20Stichtag%2031.12."},{"key":"e_1_2_13_14_1","first-page":"126","volume-title":"Cancer Registration: Principles and Methods 95","author":"Boyle P.","year":"1999"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1471082X17748083"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2021-069931"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.0887"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000846"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-025-03919-0"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.70585","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ene.70585","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.70585","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T07:53:38Z","timestamp":1778054018000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.70585"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,25]]},"references-count":18,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/ene.70585"],"URL":"https:\/\/doi.org\/10.1111\/ene.70585","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,25]]},"assertion":[{"value":"2025-05-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70585"}}