“The FDA issues advisory regarding treatment with fluoroquinolone antibacterial drugs. The tendon side effects include tendon ruptures. I was not aware of the central nervous system side effects. I posted a list of the brand names below for your information. The best known antibiotic in this class is Cipro.” Bill Chesnut, MD
(Return to New Health News, http://billchesnutmd.com/new-health-news/)
The U.S. Food and Drug Administration (FDA) is advising that the serious side effects associated with fluoroquinolone antibacterial drugs generally outweigh the benefits for patients with sinusitis, bronchitis, and uncomplicated urinary tract infections who have other treatment options. An agency safety review has shown that, when used systematically, fluoroquinolones are associated with disabling and potentially permanent serious side effects that can occur together. Side effects can involve the tendons, muscles, joints, nerves, and central nervous system. As a result, FDA is requiring the drug labels and medication guides for all fluoroquinolone antibacterial drugs to be updated to reflect this new safety information. The agency states that healthcare professionals should stop systemic fluoroquinolone treatment immediately if a patient reports serious side effects, and switch to a non-fluoroquinolone antibacterial drug to complete the patient’s treatment course.
- nalidixic acid(NegGram, Wintomylon)
- oxolinic acid(Uroxin)
- piromidic acid(Panacid)
- pipemidic acid(Dolcol)
The second-generation class is sometimes subdivided into “Class 1” and “Class 2”.
- enoxacin(Enroxil, Penetrex)
- fleroxacin(Megalone, Roquinol)
- nadifloxacin(Acuatim, Nadoxin, Nadixa)
- norfloxacin(Lexinor, Noroxin, Quinabic, Janacin)
- ofloxacin(Floxin, Oxaldin, Tarivid)
Unlike the first- and second-generations, the third-generation is active against streptococci.
- grepafloxacin(Raxar) (removed from clinical use)
- levofloxacin(Leflox, Cravit, Levaquin, Tavanic)
- pazufloxacin(Pasil, Pazucross)
- temafloxacin(Omniflox) (removed from clinical use)
- tosufloxacin(Ozex, Tosacin)
Fourth-generation fluoroquinolones act at DNA gyrase and topoisomerase IV. This dual action slows development of resistance.
- gatifloxacin(Zigat, Tequin) (Zymar -opth.) (Tequin removed from clinical use)
- moxifloxacin(Acflox Woodward, Avelox,Vigamox)
- trovafloxacin(Trovan) (removed from clinical use)
- delafloxacin— an anionic fluoroquinoline in clinical trials
- JNJ-Q2— completed Phase II for MRSA