Study: Fluoroquinolone-Corticosteroid Combo Increases Averse Effects

adverse-effects-Fluoroquinolone-Corticosteroid-combinationRecent research has found that fluoroquinolone antibiotics, especially when taken in collaboration with a corticosteroid, may be tied to increased tendon injury risks.

According to the study, researchers sought to “…determine the strength of the association between fluoroquinolone use and tendinopathy, and to identify risk factors for this complication,” according to Drug Safety Monitor.

Fluoroquinolones include the drugs Avelox and Vigamox (Moxifloxacin), Cipro (Ciprofloxacin), Factive  (Gemifloxacin), Floxin and Ocuflox (Ofloxacin), Levaquin and Quixin (Levofloxacin), and Noroxin (Norfloxacin), and are in a class of antibacterial drugs that are indicated for the treatment of a broad array of infections. The medications are broad-spectrum antibacterials that prevent bacterial cells from duplicating, Drug Safety Monitor wrote.

Corticosteroids medications are either administered alone or in conjunction with other drugs for the treatment of inflammation and other conditions in which adrenal glands under-produce steroid hormones, Drug Safety Monitor reported.

The researchers examined the results from 16 studies that involved tendonitis and tendon rupture with use of fluoroquinolones. Five studies specifically involved Achilles tendon effects and revealed that patients taking fluoroquinolones were at increased risk for Achilles tendon rupture in the first month following exposure to these medications.  Five other studies revealed that patients taking both oral corticosteroids and fluoroquinolones were at increased risk for developing tendon injury when compared to patients who were only receiving fluoroquinolone treatment. The interaction, according to Drug Safety Monitor, varied with the various fluoroquinolones.

Findings published earlier this year by the Mayo Clinic indicated that nearly 70 percent of Americans take prescription drugs; more than 50 percent of Americans take multiple medications. Antibiotics are the most commonly prescribed drug class, according to the findings, wrote Drug Safety Monitor.

Using U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) data from November 1, 1997 to December 31, 2012) that was aggregated and standardized by the AdverseEvent RxFilter process, 83,190 serious adverse events which listed fluoroquinolones as a suspect drug were revealed; of these, 41,901 described the drugs as the primary suspect. The most commonly reported side effects were: Tendon rupture, tendonitis, and arthralgia (joint pain), according to Drug Safety Monitor. The team also identified 11,518 hospitalizations and 2,499 patient deaths in which fluoroquinolones were indicated as the primary suspect.

Fluoroquinolones also have the potential for QT prolongation and other significant side effects that should be considered when choosing an antibacterial drug and have long been linked to dangerous side effects such as increased risks of suffering acute kidney failure. Avelox and Levaquin have been linked to liver injury in the elderly and, in general, fluoroquinolone antibiotics are associated with severe tendon injuries, including tendon rupture and tendonitis.

Fluoroquinolone use has also been linked to detached retinal problems. Retinal detachment can lead to permanent blindness if not surgically treated within a few days of onset.

Health Canada also previously warned that people with myasthenia gravis should avoid fluoroquinolone antibiotics because they could worsen the rare, chronic disease that causes progressive muscle weakness, including in the eye and face muscles, neck and throat muscles, and limb muscles. Another recent study found that Zithromax may increase risks for death, specifically in patients with heart disease. Also, the increasing use of potent drugs such as Cipro, Levaquin, and Avelox, has also been linked to serious antibiotic resistant infections, including antibiotic-resistant Staphylococcus aureus (MRSA) and Clostridium difficile. In fact, one study blamed fluoroquinolones for 55 percent of the C. difficile infections at one Quebec hospital.

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