Trending Clinical Topic of the Week (February 9-15): Fluoroquinolones
Safety concerns about a powerful type of antibiotic continue to garner attention, resulting in this week's top trending clinical topic. In late December of last year, the US Food and Drug Administration (FDA) issued a warning that fluoroquinolone use is associated with increased risk for aortic aneurysm. Certain patients receiving a fluoroquinolone drug have been found to be twice as likely to experience aortic dissection or aortic aneurysm, which may lead to bleeding and death. The FDA pointed to four observational studies that found this dangerous association.
In July 2018, the FDA ordered label changes to warn about the risk for serious mental health side effects and blood sugar disturbances associated with fluoroquinolone use. The new labels list mental health side effects separately from other central nervous system side effects and include disturbances in attention, disorientation, agitation, nervousness, memory impairment, and delirium. Additionally, the labels now explicitly reference the potential risk for coma with hypoglycemia.
Meanwhile, the European Medicines Agency's Pharmacovigilance Risk Assessment Committee recently recommended restricting the use of systemic and inhaled fluoroquinolone and quinolone antibiotics following a safety review. They also recommended that fluoroquinolone antibiotics not be used (1) to treat infections that might improve without treatment or are not severe, (2) to treat patients who have previously had serious side effects, or (3) to treat mild or moderately severe infections unless other antibacterial medicines cannot be used.
Although many of these changes occurred last year, they continue to have clinical implications and helped make fluoroquinolones this week's top trending clinical topic.
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Cite this: Ryan Syrek. Trending Clinical Topics for February 2019 - Medscape - Mar 01, 2019.