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Toxicity of quinolones
1Institute of Clinical Pharmacology and Toxicology, Department of Toxicology, University Medical Center Benjamin Franklin, Freie Universität Berlin, Germany.
Drugs
|December 20, 1999
Summary
Fluoroquinolones can cause adverse effects like CNS, skin, and gastrointestinal reactions. Careful consideration of specific toxic potentials, including phototoxicity and chondrotoxicity, is crucial when prescribing these antibiotics.
Area of Science:
- Pharmacology and Toxicology
- Infectious Diseases
Background:
- Fluoroquinolones are broad-spectrum antibiotics used for bacterial infections.
- Adverse effects are a significant concern with fluoroquinolone therapy, particularly with newer agents.
Purpose of the Study:
- To review the adverse effects associated with fluoroquinolone use.
- To highlight specific toxic potentials and risk factors for newer fluoroquinolone drugs.
Main Methods:
- Literature review of reported adverse effects of fluoroquinolones.
- Analysis of dose-response relationships and specific toxicities.
Main Results:
- Common adverse effects include gastrointestinal, CNS, and skin reactions.
- Newer fluoroquinolones like trovafloxacin, sparfloxacin, and grepafloxacin have specific risks such as neurotoxicity, cardiotoxicity (QT prolongation), phototoxicity, and chondrotoxicity.
- Chondrotoxicity is linked to magnesium chelation and is a concern in pediatric patients.
- Tendopathies, including tendon rupture, can occur late after treatment.
Conclusions:
- Fluoroquinolones are generally well-tolerated, but specific toxic potentials must be considered.
- Risk-benefit assessment is essential, especially for patients with pre-existing conditions or in pediatric populations.
- Avoiding concurrent use with drugs prolonging the QT interval is recommended for sparfloxacin and grepafloxacin.