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Increased risk of acute pancreatitis among tetracycline users in a Swedish population-based case–control study
  1. Rickard Ljung1,
  2. Jesper Lagergren1,2,
  3. Tomas S Bexelius1,
  4. Fredrik Mattsson1,
  5. Mats Lindblad1,3
  1. 1Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
  2. 2Division of Cancer Studies, King's College, London, UK
  3. 3Section of Upper Gastrointestinal Surgery, Gastrocenter, Karolinska University Hospital, Stockholm, Sweden
  1. Correspondence to Dr Rickard Ljung, Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery, Norra Stationsgatan 67, 2nd floor, Karolinska Institutet, SE-171 76 Stockholm, Sweden; rickard.ljung{at}


Objective To evaluate the suggested association between tetracycline and acute pancreatitis in a large pharmacoepidemiological study.

Design The use of tetracycline in relation to the risk of acute pancreatitis was examined in a nationwide case–control study of people aged 40–84 years between 2006 and 2008 in Sweden. The Swedish Patient Register was used to identify 6161 cases of first-episode acute pancreatitis. The Register of the Total Population was used to randomly select 61 637 control subjects from the general population using frequency-based density sampling, matched for age, sex, and calendar year. Tetracycline use was defined as ‘current’, ‘recent’, ‘past’ or ‘former’ if the drug had been dispensed 0–30 days, 31–180 days, 181–365 days or 1–3½ years before the index date, respectively. The risk of acute pancreatitis was estimated by unconditional logistic regression, providing ORs with 95% CIs, adjusted for potential confounding factors.

Results There was a 60% increased risk of acute pancreatitis among current users of tetracycline after adjustment for potential confounders (OR=1.6, 95% CI 1.2 to 2.1). There was no increased OR for any category of previous use.

Conclusion Current use of tetracycline is associated with an increased risk of acute pancreatitis, verifying previous case reports.

  • Antibiotics
  • pharmaco-epidemiology
  • pancreatitis
  • amylase
  • tetracycline
  • Epidemiology
  • pancreatitis
  • pharmacotherapy
  • adenocarcinoma
  • epidemiology
  • barretts carcinoma
  • oesophageal cancer
  • gastric surgery
  • gastric neoplasia
  • oesophageal reflux
  • oesophageal surgery

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  • Funding This study was supported by Swedish Research Council (SIMSAM), Bengt Ihre Foundation.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the ethical board in Stockholm, Sweden.

  • Provenance and peer review Not commissioned; externally peer reviewed.