Concerns on use of Quinolones - by Dr.T.V.Rao MD
Concerns on use of Quinolones - by Dr.T.V.Rao MD The adverse effects of fluoroquinolones include chronic fatigue, tendonitis/tendinopathy, tendon rupture, joint pain, muscle weakness/soreness/fibromyalgia, peripheral neuropathy, muscle spasms, popping/cracking joints, endurance problems, tinnitus (ringing in the ears), heart palpitations, anxiety attacks, , de-personalization, memory loss, difficulty finding the right word at times, seizures, buzzing/tingling/vibratory sensations, dry eyes/mouth/sinuses, numbness (especially at night), floaters/blank spots in field of vision, depression, and death. Peripheral Neuropathy: Rare cases of sensory or sensorimotor axonal polyneuropathy affecting small and/or large axons resulting in paraesthesia’s, hypoesthesia’s, dysesthesias and weakness have been reported in patients receiving quinolones, . The drug should be discontinued if the patient experiences symptoms of neuropathy including pain, burning, tingling, numbness, and/or weakness or other alterations of sensation including light touch, pain, temperature, position sense, and vibratory sensation in order to prevent the development of an irreversible condition." These reactions vary from minor to extremely serious. Some are disabling. Recovery varies from individual to individual, with some reactions resolving quickly and others lasting years. Nevertheless, quinolones are overused for minor conditions when other, safer antibiotics would suffice, that quinolones should be reserved for serious infections for which other antibiotics have been ineffective or for organisms that are only sensitive to quinolones. Even then, quinolones should be used carefully with close monitoring for side effects. Because quinolone reactions sometimes occur quickly, patients need to be informed so that they can alert their doctors. Unless there is a medically urgent reason to the contrary, quinolone treatment should be stopped immediately. There is a growing concern on use of Quinolones and the Bacteriology laboratories testing the Antibiotic sensitivity should give better options to Physicians on the choice of Antibiotics, Empherical treatment with Quinolones by Physicians may prove to be a concern to the patients?
A time to Stop counter sales of Quinolones in developing countries
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References Medscape /FDA
Dr.T.V.Rao MD Professor of Microbiology
Professor at Former Professor of Microbiology TMC Kollam Kerala
1 年Wonderful suggestions thank you Dr Kumar for making the matters easier to understand with regards Dr T V Rao
Head, Microbiology, Infection Prevention & Control at Almana General Hospitals Group
1 年Agree with the discussion on justified use of quinolones for the reasons described above & in our personal experience, we have noticed the following: patients treated with quinolones especially with levofloxacin are at higher risk of being colonized with MRSA & quinolone use is an important risk factor for multi drug resistant gram negative organisms more commonly noted among Pseudomonas species among intensive care & long term care patients. One of our clinical colleague following levofloxacin use collapsed which was correlated to bundle branch block & had to be intubated in the emergency room & shifted to intensive care for 5 days on ventilator support & got extubated and recovered completely. Quinolones should always be used based on antibiogram report from clinical microbiology team and as told by Dr. Rao, if possible always prefer other antibiotic classes over quinolone use. I thank Dr. Rao for discussing the quinolone use and its adverse effects & hope the practicing clinical microbiologists will implement the interventions during patient care activities.