Fluoroquinolone side effects

Gatifloxacin 400 mg once daily Not available Common fluoroquinolone side effects are nausea,... 

Rifaximin appears to be an ideal agent for the treatment of infectious watery diarrhea. It has shown excellent efficacy in numerous clinical trials of bacterial diarrhea. Its excellent side effect profile and lack of systemic absorption predict that it should be useful in treating hosts for whom the currently favored fluoroquinolones are contraindicated. Uses limited to enteric indications and its inherently low propensity to induce sustainable resistance among Gram-negative flora favor the sustained usefulness of rifaximin in the treatment of enteric syndromes. 

The data on the adverse reactions of the fluoroquinolones which have received the most extensive clinical evaluation (ciprofloxacin, ofloxacin, pefloxacin, norfloxacin and enoxacin), involving about 30,000 patients, have been the subject of a review [54a], An important point noted in this review involves the difficulty in detecting an important severe adverse reaction if it is of relatively low frequency, until there has been a very large patient exposure (some examples are provided in which at least 150,000-300,000 exposures would be required to observe the importance of side-effects, resulting in an alert, which have been discovered with specific drugs). However, the majority of side-effects observed thus far with the fluoroquinolones have been minor,... 

Enhances inhibition of DNA gyrase (i.e., fluoroquinolones) No side effects... 

Fluoroquinolones are a widely used family of antibiotics with a large number of indications and few side effects. More than 20 fluoroquinolones are on the market and... 

Fluoroquinolones are well tolerated. The most common adverse effects are nausea, vomiting, diarrhoea, headache, insomnia, skin rash and occasionally abnormal liver function tests (with trovafloxacin). Phototoxicity has been particularly reported with pefloxacin, lomefloxacin, sparfloxacin and ofloxacin. Tendinitis is a serious side effect rarely reported in adults. Because of cartilage damage in children it must be used under close supervision. 

As soon as the first case of anthrax was confirmed in Florida, a relatively new drug gained notoriety—Cipro . This fluoroquinolone (ciprofloxacin) became the mode of therapy for those people exposed to the anthrax bacillus (approved by the FDA for anthrax on July 28, 2000). Despite appeals for restraint in the use of Cipro, pharmacies in Mexican border towns reported being cleaned out of the antibiotic by Americans searching for the readily available and relatively cheap drug. Only time will tell if inappropriate, irrational use of Cipro results in loss of effectiveness in treating anthrax infection. However, the CDC did determine that 19 percent of 490 people in Florida experienced side effects 1-2 weeks after beginning therapy with Cipro. 

Carbon C. Comparison of side effects of levofloxacin versus other fluoroquinolones. Chemotherapy 2001 47(Suppl 3) 9-14 discussion 44-8. 

Rare side effects cartilage toxicity, tendon rupture, and Q prolongation. An increase in QT prolongation and torsade de pointes has been associated with the use of fluoroquinolones, particularly the newer generations. 

The newer fluoroquinolones (ciprofloxacin, norfloxacin, enoxadn, pefloxacin, gatifloxadn and moxi-floxacin) have similar toxicities and incidence of adverse effects. In general, compared to other antibiotics, these are relatively safe agents [190]. Gastrointestinal side-effects are the most common (0.8 to 6.8% of patients), followed by central nervous system manifestations (0.9 to 1.8%), and skin reactions (0.6 to 2.4%). Rare cases of increased serum creatinine levels have been reported [203]. Indeed, in a study of 133 febrile episodes in neutropenic patients comparing the effectiveness and safety of high-dose oral ciprofloxacin versus azlociUin and netilmicin, there were no renal ad-... 

The first quinolone, nalidixic acid, was isolated as a byproduct of the synthesis of chloroquine. It has been available for the treatment of urinary tract infections for many years. The introduction of fluorinated 4-quinolones, such as ciprofloxacin (Cipro), moxifloxacin (Avelox), and gatifloxacin (Tequin) represents a particularly important therapeutic advance because these agents have broad antimicrobial activity and are effective after oral administration for the treatment of a wide variety of infectious diseases. Relatively few side effects appear to accompany the use of these fluoroquinolones, and microbial resistance to their action does not develop rapidly. Rare and potentially fatal side effects, however, have resulted in the withdrawal from the market of temafloxacin (immune hemolytic anemia), trovafloxacin... 

The most common side effect of sucralfate is constipation (-2%). some aluminum can be absorbed, sucralfate should be avoided in patients with renal failure who are at risk for aluminum overload. Likewise, aluminum-containing antacids should not be combined with sucralfate in these patients. Sucralfate forms a viscous layer in the stomach that may inhibit absorption of other drugs, including phenytoin, digoxin, cimetidine, ketoconazole, and fluoroquinolone antibiotics. 

Side effects May i oral absorption of azoles, fluoroquinolones, and tetracyclines... 

E. Toxicity Gastrointestinal distress is the most common side effect. The fluoroquinolones may cause skin rashes, headache, dizziness, insomnia, abnormal liver function tests, phototoxicity. 

The nature of substituents in position 8 of flnoroquinolones also makes a certain impact on antibacterial activity. The key role of the 8-methoxy substituent is demonstrated by the fact that this fragment is a part of such effective drugs, as moxifioxacin and gatifioxacin [176-180]. Indeed, fluoroquinolone 52 shows a high activity against H. influenza and M. catarrhalis [181], while compound 53 is 4 times more active against S. pneumoniae than levofloxacin [182, 183], 8-Methoxy-6-fluoroquinolone 54 has smaller side effects on the cardio-vascular system, than gatifioxacin (Scheme 24) [184],... 

Not only [jj]-annelated fluoroquinolones, but also polycyclic fluoroquinolones, in which an additional ring is annelated to [c]- or [/ ]-sides proved to possess antineoplastic action. Research studies on antineoplastic activity of 5-cyclopropyl-6,8-difluoro-7-(2,6-dimethyl-4-pyridinyl)-5H-pyrazolo[4,3-c] quinolin-3(2H)-ones 106 have shown that derivatives containing the cyclohexyl group in position 2 are the most effective inhibitors of topoisomerase II of HeLa cells (mammalian cancer), while the dimethylaminocyclohexyl compound has shown the best data on cytotoxicity towards P388 (leukemia) cells (Table 9) [312]. 

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