Improving Quality of Care: Update of Risks Associated with Use of Fluoroquinolones
- Describe the recent U.S. Food and Drug Administration (FDA) drug safety communications for fluoroquinolones.
- Identify potential adverse effects associated with use of fluoroquinolones.
Summarize best practices for responsible prescribing of fluoroquinolones.
- Fluoroquinolones are broad-spectrum antibiotics that are FDA-approved to treat various bacterial infections, including infections caused by gram-negative bacilli.
- Over the last decade, the FDA has issued multiple drug safety communications
highlighting potential adverse events associated with use of fluoroquinolones.
- Fluoroquinolones should not be prescribed to community-dwelling patients who have other treatment options for acute bacterial sinusitis, acute bacterial exacerbation of chronic bronchitis, and uncomplicated urinary tract infection (UTI), as the risks outweigh the benefits.
- In a study of community-dwelling Medi-Cal fee-for-service beneficiaries, approximately 57% of fluoroquinolone use appeared to be for potentially inappropriate indications, based on FDA recommendations.
Fluoroquinolones, including ciprofloxacin, ofloxacin, gemifloxacin, levofloxacin, and moxifloxacin, are broad-spectrum antibiotics that interfere with the growth of bacteria via inhibition of certain enzymes needed for bacterial replication.1 Fluoroquinolones are FDA-approved to treat various bacterial infections and can be reliably used to treat infections caused by gram-negative bacilli, including strains of antibiotic resistant bacteria.1 As shown in Table 1, most fluoroquinolones appear on the Medi-Cal List of Contract Drugs, with some having restrictions to their use without an approved Treatment Authorization Request (TAR).