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Fluoroquinolone Antibiotics

 I (usually) don't give a Flox


While I usually try to refute poorly researched bad press about important medications, there is one class that's come up lately that I don't feel like people have enough of a sense of wariness about.

Fluoroquinolones are a class of antibiotic with a few different names - in the US, you've probably heard of Cipro (ciprofloxacin), Avelox (moxifloxacin - fun to say with an English accent), and Levaquin (levofloxacin).  Every now and then I have someone voice concerns about this after they read the package insert, but that's pretty rare, so I'll point out a few notes from the FDA about fluoroquinolones:

2004 - warning about risk of developing peripheral neuropathy (nerve pain or numbness in the extremities)

2008 - black box warning about permanent tendinitis and tendon rupture.  This one got some press but has been largely forgotten.  I blame the news cycle.

2011 - black box warning for exacerbating myasthenia gravis - a rare condition though so for most people not too important)

2013 - strengthened the warning about peripheral neuropathy, this time calling it potentially permanent and disabling

2016 - added a warning that it should only be used for treating COPD exacerbations, uncomplicated urinary tract infections and sinus infections in people with no other options

2018 - added three warnings on the risk of a hypoglycemic coma, mental health side effects (attention disturbance, memory impairment, agitation, disorientation, nervousness), and  aortic dissection and aortic aneurysms.

So I think we're probably on the same page now in that these medications shouldn't be used if there's any other good alternative.  I don't think this applies to eye drops in the same way as I know sometimes ofloxacin drops are used and don't get absorbed as much into the rest of the system.

If you have concerns that you or a loved one may have been affected by one of these things, unfortunately there is no test to determine the cause of any of the issues I mentioned above, it's more about thinking for the future and an ounce of prevention > pound of cure.
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