On Thursday, this week, the United States Food and Drug Administration warned that the antibiotic fluoroquinolone may possess more risks than benefits, according to research based on patient problem reports, as well as studies that were published between 2015 and 2018. The most severe of these risks could include an aortic aneurysm in some patients.
Fluoroquinolone antibiotics are used for treating very serious respiratory infections as well as things like pneumonia and urinary tract infections; they are also sometimes useful in treating the plague, exposure, or anthrax contamination. These drugs can be taken orally or through injection. They are commonly sold under names like ciprofloxacin, gemifloxacin, levofloxacin, moxifloxacin, norfloxacin, and ofloxacin, or their associated brands: Cipro, Factive, Levaquin, Avelox, Noroxin, and Floxin, respectively.
The issue at hand, though, is that these drugs can cause a condition known as an aortic aneurysm. This is a bulge in an artery which can grow too large and then burst, which can be very dangerous due to potentially fatal bleeding.
In the warning, the FDA warns that the patients most at risk for potential complications from taking this medication include the elderly, those patients who also have high blood pressure, patients with a history of aortic or blood vessel blockage, and those patients who may also have genetic conditions like Ehlers-Danlos syndrome or Marfan syndrome.
FDA Commission Dr. Scott Gottlieb comments that the “risk of an aortic aneurysm or dissection is low” but testing has revealed that patients who are prescribed fluoroquinolone (and take it consistently, of course) are at twice the risk. He notes, then, that for those patients who have an aortic aneurysm already, or are aware of their risk for an aortic aneurysm “we do not believe the benefits outweigh this risk, and alternative treatment should be considered.”
It is very important to also remind that this concern only relates to patients who fall into these risk categories. For those patients who do not satisfy these small associations, fluoroquinolones might still be a viable treatment option. After all, they have a 30-year history of helping patients suffering from various bacterial infections.
The FDA, of course, will continue to monitor these drugs for any other safety concerns that might be associated with these antibiotics.