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CURRENT ISSUE

№4' 2020

CLINICAL PHARMACOLOGY

International Medical Journal, Vol. 26., Iss. 4, 2020, P. 72−75.


DOI (https://doi.org/10.37436/2308-5274-2020-4-13)

INTERNATIONAL SEVERE WARNING REQUIREMENTS AND SMART DECISIONS IN CHOICE TACTICS FOR FLUOROQUINOLONES


Yakovleva O. O., Hoina-Kardasevich O. Yu.

National Pirogov Memorial Medical University, Vinnytsya, Ukraine

The paper is devoted to the review of the reports on current ideas about adverse reactions of using the fluoroquinolones. As a group of antibiotics with a wide range of effects on microbial pathogens, they have recently found a sufficient use in infectious diseases in clinical practice. However, the spread of indications is accompanied by the accumulation of information about the growth of adverse reactions. Among the first mentioned ones there were reactions in gastrointestinal tract, allergic reactions, photosensitization, prolongation of the QT interval, deterioration of joint and tendon function, lesions of the nervous system. Some toxic reactions contributed to the banning of certain drugs: temafloxacin, grepafloxacin, trovafloxacin. Further observations were made on the development of hypoglycemic reactions, eosinophilia, liver damage. Among the mechanisms of toxicity the free radical reactions, structural modifications of the antibiotic molecule are considered. Therefore, both the United States (FDA) and European experts are paying close attention to serious warnings to limit the indications for these drugs. Some studies have shown an increase in the frequency of tendon rupture, as well as the risk of aortic aneurysm and its rupture, due to the mechanisms of effects on collagen metabolism, widely present in the tissues of the joints and surrounding tissues and in the aorta. The reports demonstrate the frequency of lesions to joints, muscles, nervous system and separately formulated complications in the mental sphere of patients. The accumulation of information on the injury of the nervous system and mental disorders resulted in the proposal to limit the indications for the easy course of infections, with their recurrence in urinary tract infections, diarrhea prevention. Restrictions also include as follows: old age of patients, previous anamnestic reactions to these drugs, diseases of the joints and kidneys, interaction with glucocorticoids.

Key words: fluoroquinolones, adverse reactions, restrictions on indications, international recommendations.


REFERENCES


1. Dekker A. R. J., Verheij T. J. M., van der Velden A. W. Inappropriate antibiotic prescription for respiratory tract indications: most prominent in adult patients. 2015. Fam. Pract. 32. R. 401−407. doi: 10.1093/fampra/cmv019

2. Ball P. Efficacy and safety of levofloxacinin the context of other contemporary fluoroquinolones: A review // Current Therapeutic Research. 2003. Vol. 64, № 9.

3. Golomb B. A., Koslik H. J., Redd A. J. Fluoroquinolone−inducedserious, persistent, multi symptom adverse effects // BMJ CaseRep. 2015. bcr2015209821. doi: 10.1136/bcr−2015−209821

4. Akali A. U., Niranjan N. S. Management of bilateral Achilles tendon rupture associated with ciprofloxacin: a review and case presentation // J. Plast. Reconstr. Aesthet. 2008. Surg. 61. R. 830−834. doi: 10.1016/j.bjps.2006.08.005

5. Popescu C. Severe Acute Axonal Neuropathy Induced by Ciprofloxacin: A Case Report. 2018. CaseRep. Neurol. 10. R. 124−129. doi: 10.1159/000489303

6. Mandell L., Tillotson G. Safety of fluoroquinolones: An update // Can. J. InfectDis. 2002. № 13 (1). R. 54−61.

7. Blum M. D., Graham D. J., McCloskey C. A. Temafloxacin syndrome: A review of 95 cases // Clin. Infect Dis. 1994. № 18. R. 946−950. doi: https://doi.org/10.1093/clinids/18.6.946

8. Pfizer relabels antibiotic Trovan for serious infections. Doctors Guide (e−mailedition), August 30, 1999. URL: http://www.pslgroup.com/dg/106B6.htm

9. Ball P. Quinolone−induced QT interval prolongation: A not−sounexpected class effect // J. Antimicrob. Chemother. 2000. Vol. 45. P. 557−559. doi: https://doi.org/10.1093/jac/45.5.557

10. Chen J. L., MacLean J. A. Trovafloxacin associated eosinophilic hepatitis // N Engl. J. Med. 2000. Vol. 342. P. 359−360.

11. Childs S. Safety of the fluoroquinolone antibiotics; focus on the molecular structure // Infect. Urol. 2000. Vol. 13. P. 3−10.

12. Daneman N., Bronskill S. E., Gruneir A. Variability in Antibiotic Use Across Nursing Homes and the Risk of Antibiotic−Related Adverse Outcomes for Individual Residents // JAMA Intern Med. 2015. Vol. 175 (8). P. 1331−1339. doi:10.1001/jamainternmed.2015.2770

13. Daneman N., Lu H., Redelmeier A. Fluoroquinolones and collagen associated severe adverse events: a longitudinal cohort study // BMJ Open. 2015. Vol. 5 (11). e010077. doi: https://doi.org/10.1136/bmjopen−2015−010077

14. Pasternak B., Inghammar M., Svanstrom H. Fluoroquinolone use and risk of aortic aneurysm and dissection: nationwide cohort study // BMJ. 2018. Vol. 360. k678. doi: https://doi.org/10.1136/bmj.k678

15. Higdon E., Twilla J. D., Sands C. Moxifloxacin−Induced Visual Hallucinations: A Case Report and Review of the Literature // J. Pharm. 2017. Pract. 30. P. 375−377. doi: 10.1177/0897190016637987

16. Mattappalil A., Mergenhagen K. A. Neurotoxicity with antimicrobials in the elderly: a review // Clin. Ther. 2014. Vol. 36. P. 1489−1511. doi: 10.1016/j.clinthera.2014.09.020

17. Mazhar F., Akram S., Haider N. Moxifloxacin−induced acute psychosis: A case report with literature review // J. Res. Pharm. 2016. Pract. 5. P. 294. doi: 10.4103/2279−042x.192457

18. Scavone C., Mascolo A., Ruggiero R. Quinolones−Induced Musculoskeletal, Neurological, and Psychiatric ADRs: A Pharmacovigilance Study Based on Data From the Italian Spontaneous Reporting System // Front Pharmacol. 2020. Vol. 11. P. 428. doi: https://doi.org/10.3389/fphar.2020.00428

19. European Association of Urology (2018). EAU Guidelines on Urological Infections. Availableat: https://uroweb.org/wp−content/uploads/EAU−Guidelines−on−Urological−Infections−2018−large−text.pdf [AccessedFebruary 12, 2020].

20. Hori S., Shimada J., Saito A. Comparison of the inhibitory effects of new quinolones on gamma−aminobutyric−acid receptor binding in the presence of anti−inflammatory drugs // Rev. Infect. Dis. 1989. Suppl. 5. P. 1397−1398.

21. Ultrastructure of Achilles tendon of rats treated with ofloxacin and fed a normal or magnesium deficient diet / M. Shakibaei et al. // Antimicrob. Agent. Chemother. 2000. Vol. 44. P. 261−266. doi: https://doi.org/10.1128/aac.44.2.261−266.2000

22. The safety of quinolones − a meta−analysis of pregnancy outcomes / B. Bar−Oz et al. // Eur. J. Obstet. Gynecol. Reprod. Biol. 2009. Vol. 143. P. 75−78.

23. The safety of quinolones in pregnancy / E. Yefet et al. // Obstet. Gynecol. Surv. 2014. Vol. 69. P. 681−694.

24. Muanda F. T., Sheehy O., Berard A. Use of antibiotics during pregnancy and risk of spontaneous abortion // CMAJ. 2017. Vol. 189. P. 625−633. doi: https://doi.org/10.1503/cmaj.161020

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