Podcast #387: Fluoroquinolones are Perfectly Safe?

Author: Don Stader, MD

Educational Pearls:

• Fluoroquinolones can cause connective tissue disruption leading not only to tendon rupture but also aortic dissection

• Retrospective study from Taiwan showed over a 2x higher rate of dissection when exposed to fluoroquinolones (1.6% vs 0.6%)

• Remember to think about aortic dissection when you have a patient with chest pain that travels and/or involves neurologic symptoms

• Try to use fluoroquinolones when no other appropriate antibiotic exists as they have significant other side effects as well

Editor's note: In July 2018, the FDA required strengthening of warning labels on fluoroquinolones about the risks of mental health effects and hypoglycemia

References:

Lee CC, Lee MG, Hsieh R, Porta L, Lee WC, Lee SH, Chang SS. Oral Fluoroquinolone and the Risk of Aortic Dissection. J Am Coll Cardiol. 2018 Sep 18;72(12):1369-1378. doi: 10.1016/j.jacc.2018.06.067. PubMed PMID: 30213330.

Khaliq Y, Zhanel GG. Fluoroquinolone-associated tendinopathy: a critical review of the literature. Clin Infect Dis. 2003 Jun 1;36(11):1404-10. Epub 2003 May 20. Review. PubMed PMID: 12766835.

https://www.fda.gov/downloads/Drugs/DrugSafety/UCM612834.pdf

Summary by Travis Barlock, MS4 | Edited by Erik Verzemnieks, MD