| アブストラクト | PURPOSE: beta-Lactam antibiotics are generally considered safe, but neurotoxicity has been reported. These reports mainly involve adults; however, evidence in children remains limited. Although febrile seizure (FS) is the most common type of seizure in early childhood, multiple factors contribute to FS onset, and a potential association with beta-lactam exposure has not been fully examined. We therefore investigated the association between oral beta-lactam antibiotics and FS using a case-crossover design with an active comparator. METHODS: Children younger than 6 years who experienced an incident FS were identified from a Japanese health insurance claims database. Exposure to oral beta-lactam antibiotics was assessed on the hazard date (day -1) and the control date (day -22), while oral macrolides served as the active comparator. Conditional logistic regression was used to estimate odds ratios (ORs), and comparator-adjusted ORs were derived by dividing beta-lactam ORs by macrolide ORs. The attributable fraction among the exposed (AFe) was calculated from the comparator-adjusted OR. RESULTS: We identified 43,936 children. The comparator-adjusted OR for FS with oral beta-lactam exposure was 1.21 (95% confidence interval [CI], 1.03-1.40). These results were generally consistent across sensitivity analyses in which the control date was shifted from day -22 to day -15 or day -29. CONCLUSION: Oral beta-lactam antibiotics were associated with a modestly increased risk of FS. This finding should be interpreted cautiously because residual time-varying confounding by infection severity and fever may remain. Clinically indicated beta-lactam antibiotics should not be withheld on the basis of these findings alone. |
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| 組織名 | Department of Pharmacoepidemiology, Graduate School of Medicine and Public;Health, Kyoto University, Kyoto, Japan; Patient Safety Division, Research and;Development, AstraZeneca K.K., Osaka, Japan.;Health, Kyoto University, Kyoto, Japan. Electronic address:;yanai.takanori.7f@kyoto-u.ac.jp.;Health, Kyoto University, Kyoto, Japan.;Health, Kyoto University, Kyoto, Japan; Department of General Internal Medicine,;National Hospital Organization Kyoto Medical Center, Kyoto, Japan. |
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