To assess whether pandemic-related changes in healthcare seeking and recording affected estimates of the association between fluoroquinolone use and tendon rupture, compared with cephalosporin use.
Approach:
Design: Replicated a published cohort study and compared treatment-effect estimates across four analyses with different exposure and outcome ascertainment periods: pre-pandemic data for both, pre-pandemic exposure with outcome data spanning all periods, the complete dataset for both, and post-pandemic data for both. In the first analysis, follow-up was censored at pandemic onset.
Data and population: Used linked CPRD Aurum primary-care records, Office for National Statistics death records, and Hospital Episode Statistics hospital records. Included adults receiving a first systemic fluoroquinolone or cephalosporin prescription from 1 January 2006 to 31 March 2023, with the required prior registration and data linkage, and excluded those with a tendon rupture diagnosis in the preceding year.
Period definitions: Defined the pandemic period as beginning 16 March 2020 and the post-pandemic period as beginning 17 April 2022.
Interpretation:
The supplied context describes the study rationale and methods but does not include results or effect estimates.
Limitations:
The supplied article context ends during the methods section and does not include study results.
Tendon rupture was identified from diagnostic records entered by primary-care or hospital clinicians and was not necessarily specialist-confirmed.
