Fluoroquinolone Adverse Effects and Drug Interactions

  title={Fluoroquinolone Adverse Effects and Drug Interactions},
  author={Douglas N. Fish},
  journal={Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy},
  • D. Fish
  • Published 1 October 2001
  • Biology, Medicine, Chemistry
  • Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
Extensive pharmacologic and clinical development of quinolone antimicrobial agents has resulted in improved antimicrobial activity, pharmacokinetic features, toxicity, and drug‐drug interaction profiles. Nalidixic acid and other early quinolones had limited use due to poor pharmacokinetics, relatively narrow antimicrobial spectrum of activity, and frequent adverse effects. Beginning with the development of fluoroquinolones, such as norfloxacin and ciprofloxacin, in the 1980s, the agents assumed… 

Circumventing Drug Interactions

The ability to prevent or minimize adverse drug interactions is of vital importance in optimizing the appropriate and effective use of antimicrobials and enhancing patient outcome.

Integrating Fluoroquinolones into the Hospital Formulary

Comparative drug costs, as well as costs associated with potential clinical failure and adverse events, should be evaluated carefully, and shorter durations of therapy and less frequent dose administration may lead to reduced labor costs and increased patient compliance, thereby improving effectiveness and economic efficiency.

Safety and tolerability of fluoroquinolones.

Fluoroquinolones for the treatment of outpatient community-acquired pneumonia.

Clinical Safety Profile of Fluoroquinolones

The purpose of this paper is to review the adverse events associated with fluoroquinolone therapy, with an emphasis on safety profiles of ciprofloxacin, levofloxac in, gatifloxACin, moxiflOxacin and gemifl oxacin.

The use of fluoroquinolones in the treatment of skin infections

Despite their appeal in the treatment of both uncomplicated and complicated skin infections, the fluoroquinolones should be reserved as alternatives to β-lactams and other antibiotics or as empirical therapy in complicated infections until pathogens have been identified and drug regimens can be focused.

Levofloxacin-Associated Mania: A Case Report.

A middle-aged woman treated with levofloxacin after cholecystectomy, who developed mania that resolved after specific treatment with risperidone and lorazepam is reported, suggestive of possible diagnosis of levoquinolones-induced mania.

Safety Profile of the Respiratory Fluoroquinolone Moxifloxacin

The data show that using moxifloxacin, in its accepted indications and following the corresponding guidelines, should not be associated with an excessive incidence of drug-related adverse reactions, provided the clinician takes care in identifying patients with known risk factors and pays due attention to the contraindications and warnings mentioned in the labelling.



Overview of fluoroquinolone safety.

Drug‐Drug Interactions With Fluoroquinolones

Clinicians must be aware of these and other potential drug‐drug interactions with fluoroquinolones for optimal use of the agents.

Levofloxacin. A review of its antibacterial activity, pharmacokinetics and therapeutic efficacy.

Clinical trials recruiting non-Japanese patients are in progress and these results will form a basis on which future recommendations for the broader use of levofloxacin can be made, as it has potential as a broad spectrum antibacterial drug in the treatment of a variety of infections.

Interactions of fluoroquinolones with other drugs: mechanisms, variability, clinical significance, and management.

The safe and effective use of fluoroquinolone antibiotics requires careful consideration of concomitant drug therapy, and the metabolism of theophylline and caffeine is inhibited by enoxacin and ciprofloxacIn, and reduction of the theophyLLine dosage is not routinely required.

Ciprofloxacin. An updated review of its pharmacology, therapeutic efficacy and tolerability.

Ciprofloxacin has retained its excellent activity against most Gram-negative bacteria, and fulfilled its potential as an important antibacterial drug in the treatment of a wide range of infections.

Pharmacokinetics and pharmacodynamics of newer fluoroquinolones.

  • G. Stein
  • Biology, Medicine
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 1996
Increased microbiological potency against several important pathogens, along with an enhanced pharmacokinetic profile, will make these newer fluoroquinolones preferable over older compounds for the treatment of a variety of infections.

Levofloxacin, a Second‐Generation Fluoroquinolone

Levofloxacin had impressive efficacy in clinical studies of community‐acquired pneumonia, acute bacterial exacerbations of chronic bronchitis, acute sinusitis, skin and skin structure infections, and complicated urinary tract infections and pyelonephritis.

Neurotoxicity of antibacterial therapy.

The increasing variety of drugs available for the treatment of bacterial infections has simultaneously increased the potential for toxicity. Neurologic toxicity of antibacterial therapy is generally

Fluoroquinolone toxicity profiles: a review focusing on newer agents.

  • Benjamin A LipskyC. Baker
  • Biology, Medicine
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 1999
Fluoroquinolones are safe in elderly, human immunodeficiency virus-infected, and neutropenic patients, but because of possible effects on articular cartilage, they are not currently recommended for children or pregnant women.

Safety profile of the quinolones.

  • R. Stahlmann
  • Biology, Medicine
    The Journal of antimicrobial chemotherapy
  • 1990
Overall, fluoroquinolones are well tolerated and the incidences of side effects are similar to those of other antibacterials.