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Aifa: limiting fluoroquinolone antibiotics, possible risks – Medicine

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Aifa: limiting fluoroquinolone antibiotics, possible risks – Medicine

Based on data from recent studies, fluoroquinolone antibiotics “continue to be prescribed outside their recommended uses”. However, since “they are associated with very rare but serious, disabling, long-lasting and potentially irreversible adverse reactions”, these medicines must be prescribed “only in the approved indications and after a careful evaluation of the benefits and risks on the individual patient”. This is indicated by a note published by the Italian Medicines Agency, in agreement with the European Medicines Agency.

The European Medicines Agency has strongly recommended limiting the use of fluoroquinolones (ciprofloxacin, delafloxacin, levofloxacin, lomefloxacin -moxifloxacin, norfloxacin, ofloxacin, pefloxacin, prulifloxacin, rufloxacin) to systemic and inhaled use following a review to evaluate the risk of “serious and long-lasting, disabling and potentially irreversible adverse reactions affecting the musculoskeletal and nervous systems”. Serious adverse reactions may include tendonitis, tendon rupture, pain in extremity, gait disturbance, neuropathies, depression, fatigue, memory impairment, hallucinations, psychosis, sleep disturbances, and sensory disturbances.
They should therefore not be prescribed for patients who have had serious adverse reactions with a quinolone antibiotic, patients with minor infections (such as pharyngitis, tonsillitis and acute bronchitis), mild to moderate infections (including uncomplicated cystitis, exacerbation of chronic bronchitis, rhinosinusitis bacterial infection and acute otitis media) unless other antibiotics recommended for these infections are deemed inappropriate. Nor should they be used to prevent traveler’s diarrhea or recurring lower urinary tract infections

In particular, points out Aifa, tendon damage can occur within 48 hours of treatment or several months after the interruption and the risk is greater in patients treated with corticosteroids, in the elderly, people with renal insufficiency or who have undergone transplants.

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