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Fluoroquinolone-induced serious, persistent, multisymptom adverse effects.

Beatrice Alexandra Golomb¹, Hayley Jean Koslik¹, Alan J Redd²

¹Department of Medicine, University of California, San Diego, La Jolla, California, USA.

BMJ Case Reports

|October 7, 2015

Summary

Fluoroquinolones (FQs) can cause severe, disabling symptoms like tendinopathy and neuropathy that persist after use. This mitochondrial toxicity may lead to a severe multisymptom condition.

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Area of Science:

Pharmacology
Neurology
Toxicology

Background:

Fluoroquinolones (FQs) are broad-spectrum antibiotics.
Potential adverse effects of FQs are increasingly recognized.

Observation:

Four previously healthy adults developed severe, multisystem symptoms during or after FQ use.
Symptoms included tendinopathy, muscle weakness, neuropathy, autonomic dysfunction, sleep and cognitive disturbances, and psychiatric issues.

Findings:

Symptoms persisted and progressed even after FQ discontinuation.
The observed pathology aligns with FQ-induced delayed mitochondrial toxicity.
This suggests a potential mechanism for fluoroquinolone-induced mitochondrial neurogastrointestinal encephalomyopathy.

Implications:

Physicians and patients should be aware of the risk of severe, persistent FQ toxicity.
Early recognition and discontinuation of FQs may be crucial.
Further research into FQ-induced mitochondrial dysfunction is warranted.