2023-12-29 07:00:05
Previously widely used in the treatment of certain bacterial infections, particularly urinary infections, fluoroquinolones are prescribed less and less. Prescriptions in community medicine have been reduced by almost 60% in 10 years. The cause is their sometimes significant side effects. Explanations.
Fluoroquinolones, antibiotics with major side effects
Fluoroquinolones are a class of antibiotics very useful for the treatment of certain bacterial infections. They are used in particular to treat urinary infections, but also ear infections. Currently, seven fluoroquinolones are available in Francein oral or injectable form:
Ciprofloxacin; Levofloxacin; Ofloxacin; Norfloxacin; Moxifloxacin; Lomefloxacin; Delafloxacin.
Although their effectiveness is no longer in doubt, these antibiotics also present side effects, sometimes serious:
A photosensibilisation (sensitivity to the sun linked to taking the antibiotic); Of the troubles neuropsychiatriques: insomnia, fatigue, depression, memory disorders, sensory disorders (sight, hearing, smell, taste); Peripheral neuropathies (peripheral nerve damage): sensory and/or motor disorders mainly affecting the extremities of the lower limbs); Musculoskeletal disorders (pain and swelling of the joints, inflammation or even tendon rupture, such as the Achilles tendon, muscle pain and/or weakness. Read also – Fluoroquinolones and quinolones: new recommendations from the ANSM following a re-evaluation by the EMA
Antibiotics reserved for certain infections
In recent years, pharmacovigilance data have shown that these side effects might last over time, become disabling and sometimes irreversible. They can appear during treatment, but also several months following taking a fluoroquinolone. They can also be linked to successive antibiotic treatments. Faced with these major side effects, the European Medicines Agency reassessed the benefit/risk ratio of fluoroquinolones in 2018 and 2019. Following this work, public health authorities have restricts the therapeutic indications of these antibiotics and updates their safety profile.
At the same time, additional analyzes were carried out following the observation very rare but serious cardiac side effects. Given the potential severity of side effects, fluoroquinolones should only be prescribed in a limited number of settings, and only when there is no other antibiotic effective once morest the infection being treated. Each time, the doctor must evaluate the benefits and risks of prescribing a fluoroquinolone. Certain patients are particularly exposed to the risk of side effects:
Old people ; Subjects with renal insufficiency; Transplant patients; Patients undergoing treatment with corticosteroids. Read also – Cystitis, angina: antibiotics at the pharmacy without a medical prescription?
Inform patients of the risks and signs to watch for
Patients must be precisely informed of the risks associated with taking a fluoroquinolone and the signs to watch for throughout treatment: swelling or joint pain, muscle pain, tendinitis, sensory disturbances, difficulty breathing, etc. At the slightest suspicious sign, patients should immediately seek the advice of a healthcare professional. In some cases, emergency medical treatment is necessary.
Despite these major side effects, fluoroquinolones remain antibiotics essential to treat certain bacterial infections, sometimes serious or even fatal. However, they should not be prescribed in the following cases:
A non-severe bacterial infection or one that heals spontaneously; Prevention of turista, traveler’s diarrhea; Prevention of recurrent lower urinary tract infections; Non-bacterial infections, such as non-bacterial prostatitis; Moderate to severe infections except when other antibiotics are unsuitable: uncomplicated cystitis, acute exacerbation of COPD (Chronic Obstructive Pulmonary Disease), sinusitis or acute otitis media.
Fluoroquinolones cannot also be prescribed to patients who have already experienced side effects when previously taking these antibiotics.
Read also – Corticosteroids over a few days: watch out for side effects
Written by Estelle B., Doctor of Pharmacy on September 3, 2028 and updated on December 29, 2023.
Sources
– Fluoroquinolones. www.conseil-national.medecin.fr. Accessed December 15, 2023
– Fluoroquinolones. ANSM. ansm.sante.fr. Accessed December 15, 2023.
– Antibiotics from the fluoroquinolone family administered systemically or inhaled: reminder of the restrictions on use. ansm.sante.fr. Accessed December 15, 2023.
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