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Safety concerns with fluoroquinolones.
Allana J Mehlhorn1, Dana A Brown
1Department of Pharmacy Practice and Administration, Lloyd L Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL 33416, USA. allana_mehlhorn@pba.edu
The Annals of Pharmacotherapy
|October 4, 2007
Summary
Fluoroquinolones can cause serious adverse effects, including blood glucose alterations, QTc prolongation, seizures, phototoxicity, tendon issues, and Clostridium difficile-associated diarrhea. Careful patient monitoring and risk-benefit assessment are crucial for safe use.
Area of Science:
- Pharmacology and Medicinal Chemistry
- Clinical Safety and Therapeutics
Background:
- Fluoroquinolones are broad-spectrum antibiotics with a complex safety profile.
- Adverse events associated with fluoroquinolone use require thorough understanding for safe clinical practice.
Purpose of the Study:
- To comprehensively review the chemistry, pharmacology, and safety of fluoroquinolones.
- To identify and synthesize data on the adverse effects of fluoroquinolones.
Main Methods:
- Extensive literature search of MEDLINE (1966-July 2007) using keywords related to fluoroquinolones and adverse effects.
- Review of medicinal chemistry, in vitro, animal, and human trials, including clinical trials and literature on serious adverse event pathology.
Main Results:
- Gatifloxacin is associated with increased hospitalization risk for dysglycemia.
- All fluoroquinolones carry risks of hyperglycemia, hypoglycemia (especially with concomitant diabetes medications), QTc prolongation, tendinopathy, seizures, phototoxicity, and Clostridium difficile-associated diarrhea (CDAD).
Conclusions:
- Clinicians must be aware of potential fluoroquinolone-associated adverse effects, including blood glucose changes, QTc prolongation, seizures, phototoxicity, tendinopathy, and CDAD.
- Close monitoring and dose adjustment are essential to mitigate risks, with a risk-benefit assessment recommended for fluoroquinolone use.
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