Doctors still prescribe this antibiotic for many diseases from sinusitis, pneumonia, and bronchitis to urinary tract infections.
An antibiotic commonly used to treat many forms of infection has previously lost 30% of its effectiveness. Not only that, doctors are increasingly discovering its alarming side effects.
These pills belong to a class of antibiotics called fluoroquinolone, which has appeared many times in the recommendation of the US Food and Drug Administration (FDA).
Fluoroquinolone antibiotics include: ciprofloxacin (Cipro), gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), norfloxacin (Noroxin), and ofloxacin (Floxin).
In rare cases, fluoroquinolone can cause severe damage to the tendons and ligaments, in cases of necrosis. Many other side effects have been reported in recent years.
Now, face both antibiotic resistance, doctors and experts recommend: all drugs belonging to the fluoroquinolone class should be used as carefully as possible.
The first side effects of the fluoroquinolone antibiotic class appeared faintly in the 1970s. That’s when thousands of people used this antibiotic, during the testing phase before it was licensed.
Then, because the side effects are unclear, fluoroquinolone is still used very popularly. Doctors still prescribe this antibiotic for all common infections, from sinusitis, pneumonia, bronchitis and urinary tract inflammation.
But the more it is used, in addition to the fluoroquinolone fading, due to antibiotic-resistant bacteria, its side effects have begun to increase.
A noticeable effect of this antibiotic strain is that it affects the tendons and ligaments. Scientists do not yet know the specific mechanism of this, but they believe that fluoroquinolone antibiotics negatively affect blood flow to collagen in muscles, which will create tendons and ligaments.
In 2008, the US Food and Drug Administration (FDA) issued a regulation stating that all fluoroquinolone drugs must have a black label warning of the risk of tendinitis after use. Until 2015, FDA issued a warning about permanent nerve damage related to this drug.
In May 2016, fluoroquinolone was again warned by FDA. Now, they recommend that doctors should only use fluoroquinolone as a last-class antibiotic, meaning that it will only be used if other antibiotics are ineffective.
Earlier, many agencies and organizations working in the US health sector, such as the Association for Infectious Diseases, American Society of Chest Diseases and Obstetrics and Gynecology, recommended fluoroquinolone transfer from a first-line drug (ie used immediately and effectively) into a medicine that is used only after another antibiotic has failed.
However, it must be said that from making recommendations until it is followed by each doctor and patient is a long process. Studies in the US show that the amount of fluoroquinolone prescription outside the hospital is still high and there is no significant decrease.
In addition to the worrying side effects of fluoroquinolone, there is still a reason doctors should move this antibiotic as far as possible compared to the first treatment option. We know that when any antibiotic is used too much, the bacteria will develop resistance to the drug, making the entire class of antibiotics ineffective.
One particular thing with fluoroquinolone, is that this antibiotic class is extremely sensitive to create drug-resistant viruses. Previously, the effectiveness of treating infections such as sinoroquinolone sinusitis and urinary tract was up to 100%. However, current statistics show that it is only 70% effective.
Dr. B. Joseph Guglielmo, principal of the School of Medicine at the University of California San Francisco, said: “This was not predicted at the time when this drug appeared. Everyone thinks it’s a great antibiotic. But bacteria are always smarter than we think.
Now, when the effectiveness of fluoroquinolone is reduced, doctors will need to consider the side effects of this drug. The reason for treatment, we must always compare the benefits and harms of drugs.
“What is happening at this point is that when the potency of the drug becomes an increasingly important issue, its toxicity becomes a more important issue,” said Dr. Gugglielmo. “If you have a drug that is not as effective as before, you will have to come back to consider the reasons for not using it.”
Some studies show that the side effects of fluoroquinolone are more common in the elderly and steroid users. Therefore, the recommendation for doctors is that before prescribing, they must ask patients about steroid use and their history of tendon disease.
Besides, we still have to continue to update information from fluoroquinolone studies, potential side effects of this antibiotic and consider which cases should be used.