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Fluoroquinolone antibiotics

We would like to inform you about the use of antibiotics containing fluoroquinolones:
 
— These antibiotics can cause serious and potentially irreversible side effects. For this reason, in 2019 the use of these antibiotics was restricted.

— However, recent study data suggest that despite the restrictions, fluoroquinolones continue to be prescribed and used outside the recommended indications.

— Fluoroquinolones are a group of antibiotics used to treat bacterial infections. They are used both systemically and by inhalation. Some common fluoroquinolones are ciprofloxacin, delafloxacin, levofloxacin, moxifloxacin, norfloxacin, and ofloxacin.

— It is important to note that fluoroquinolones should only be prescribed in specific cases and should not be used for mild or moderate infections such as pharyngitis, tonsillitis, acute bronchitis or uncomplicated cystitis. These antibiotics should also be avoided in the case of non-bacterial infections such as chronic prostatitis or to prevent traveler's diarrhea.

— If you are prescribed fluoroquinolones, you should take special care if you are taking corticosteroids, are elderly, have reduced kidney function or have had an organ transplant. There is an increased risk of tendonitis and tendon rupture.

— It is indispensable that you are informed about the risk and that you see a doctor at the first sign of any side effects before continuing treatment.

— Some possible side effects of fluoroquinolones are tendinitis, tendon rupture, arthralgia, pain in extremity, gait disturbance, neuropathy with paraesthesia, depression, fatigue, memory impairment, hallucinations, psychosis, sleep disturbance and sensory impairment (hearing, vision, taste, smell). Tendon damage can occur within 48 hours or with a latency of several months after stopping treatment.

— We would also like to advise you that there is a risk of aortic aneurysms/dissections and heart valve regurgitation/insufficiency. If you are at risk for these conditions, you should only take fluoroquinolones after careful benefit-risk assessment.

— It is important that you are aware that fluoroquinolones should only be prescribed for approved indications and only after careful benefit/risk assessment.

 

— You should not take systemic and inhaled fluoroquinolones:
 

  • If you have previously had serious side effects related to a quinolone or fluoroquinolone antibiotic.

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  • To treat non-severe or self-limiting infections (e.g., pharyngitis, tonsillitis, acute bronchitis).

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  • For the treatment of mild or moderate infections (including uncomplicated cystitis, acute exacerbation of chronic bronchitis and chronic obstructive pulmonary disease, acute bacterial rhinosinusitis, acute otitis media), unless commonly recommended antibiotics are considered inappropriate.

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  • For nonbacterial infections (e.g., nonbacterial [chronic] prostatitis)

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  • For the prevention of travelers' diarrhea or recurrent lower urinary tract infections.

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