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[Serious side effects of fluoroquinolones: low risk of connective tissue-related disorders such as aneurysms]

J Boes1, A S M Dofferhoff2, H W H A Fleuren3

  • 1Radboudumc, afd. Longziekten, Nijmegen.

Nederlands Tijdschrift Voor Geneeskunde
|December 17, 2020
PubMed

Insights

The Dutch medicines board warned about fluoroquinolone antibiotics and aortic aneurysms. However, evidence for a causal link is limited, with a low absolute risk despite serious potential outcomes.

Area of Science:

  • Pharmacology
  • Cardiovascular Medicine
  • Public Health

Background:

  • Fluoroquinolones are widely prescribed antibiotics.
  • A recent warning from the Dutch medicines evaluation board (CBG) highlighted potential risks of aortic aneurysms and dissections associated with fluoroquinolone use.

Observation:

  • A review of the three articles underpinning the CBG warning was conducted.
  • The evidence supporting a causal relationship between fluoroquinolones and aortic aneurysms/dissections was assessed as limited.

Findings:

  • A hazard ratio of approximately 2 was observed for the association between fluoroquinolones and aortic aneurysms.
  • The absolute risk remains low due to the low prevalence of these conditions in the general population.

Implications:

  • Aortic aneurysms and dissections are critical, life-threatening conditions requiring serious consideration.
  • Recommendations are provided for managing patients with pre-existing aortic aneurysms or multiple risk factors for these conditions.

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