Antibiotics can permanently limit the quality of life

Fluoroquinolones: Potentially re-evaluated for potentially permanent side effects of antibiotics

Health experts repeatedly criticize doctors for prescribing high-risk antibiotics too often. Also frequently mentioned in this connection are fluoroquinolones. These medications can be associated with serious, quality-of-life and potentially long-lasting side effects.

Medicines with unwanted side effects

Although the use of antibiotics is clinically necessary in the treatment of many diseases, it is often viewed critically. Finally, studies have shown that such drugs are often associated with serious side effects. Particularly criticized are fluoroquinolone-containing agents. These can cause long-lasting, impairing the quality of life and possibly permanent side effects, especially on the tendons, muscles, joints and nervous system. Therefore, the European Medicines Agency EMA wants to severely restrict its regulation.

Antibiotics often cause serious side effects. Especially fluoroquinolone-containing preparations are critically evaluated. The regulation of such funds should now be more restricted. (Image: nenetus / fotolia.com)

Important broadband antibiotics

According to the German Federal Institute for Drugs and Medical Devices (BfArM), fluoroquinolones and quinolones are a class of broad-spectrum antibiotics that are active against both various Gram-positive and Gram-negative bacteria.

These medicines are an important treatment option against various infectious diseases, including some life-threatening ones where other antibiotics are not sufficiently effective.

However, the administration of the preparations is also associated with undesirable side effects, and therefore the Pharmacovigilance Risk Assessment Committee (PRAC) at the European Medicines Agency (EMA) has recommended restricting their use.

The reason for this is a reassessment of the serious, quality-of-life and potentially long-lasting side effects associated with the fluoroquinolones and quinolones group of drugs, which are taken orally, injected or inhaled, the BfArM reports.

Patients are advised to stop treatment at the first sign of side effects affecting the muscles, tendons, or joints, or the nervous system.

Limited use

According to BfArM, the restrictions on fluoroquinolone-containing antibiotics mean that they should not be used:

• for the treatment of infections which disappear without treatment or which are not severe (e.g. inflammation of the neck).
• for the treatment of non-bacterial infections, e.g. non-bacterial (chronic) prostatitis.
• for the prevention of traveler's diarrhea or recurrent lower urinary tract infections (those that do not go beyond the bladder).
• For the treatment of mild to moderate infections, unless other antibiotics commonly recommended to treat these infections can not be used.

In addition, it is important that the use of fluoroquinolones should generally be avoided in patients who have previously experienced serious side effects related to the use of fluoroquinolones or quinolones.

And they should be used with extra caution in the elderly, in patients with renal impairment, and in those who have had an organ transplant because these groups of patients are at greater risk for tendon damage.

Because the use of a corticosteroid with a fluoroquinolone also increases this risk, the combined use of these two groups of drugs should be avoided.

Information for patients

• Fluoroquinolone-containing medicines containing ciprofloxacin, levofloxacin, lomefloxacin, moxifloxacin, norfloxacin, ofloxacin, pefloxacin, prulifloxacin, or rufloxacin can cause long-lasting, impaired quality of life and potentially long-lasting side effects, especially on the tendons, muscles, joints, and nervous system.
• These serious side effects include tendon inflammation or tears, muscle pain or weakness, joint pain or joint swelling, difficulty walking, feelings of pinpricks or tingling, burning pain, fatigue, depression, memory problems, sleep disorders, vision or hearing problems, altered taste or smell.
• Tendinitis and tendon injuries can occur within two days after the start of treatment with a fluoroquinolone but also only a few months after the end of treatment.
• Stop taking the fluoroquinolone and contact your doctor immediately
• at the first sign of a tendon injury such as tendon pain or tendon swelling - make the affected areas calm.
• if you feel pain, needlesticks, tingling, tickling, numbness or burning or weakness, especially in the legs or arms.
• If you have swelling in the shoulders, arms or legs, difficulty walking, feeling tired or depressed, experiencing memory or sleep disturbances or seeing changes in vision, taste, smell or hearing. You will decide with your doctor if the treatment will continue or if you need another type of antibiotic.
• You may be more susceptible to joint pain or joint swelling or tendon tears if you are over 60 years of age, your kidney function is impaired, or you have had an organ transplant.
• If you are taking a corticosteroid (such as hydrocortisone and prednisolone) or need treatment with a corticosteroid, talk to your doctor. You may be particularly prone to tendon damage if you take a corticosteroid and a fluoroquinolone over the same period of time.
• You should not take fluoroquinolone if you have had severe side effects with a fluoroquinolone or quinolone and you should contact your doctor immediately.

If you have questions or concerns about your medicine, talk to your doctor or pharmacist. (Ad)