Fluoroquinolones NOT recommended for community acquired pneumonia and other such chest infections.
Adverse events associated
with levofloxacin "We studied a case
series of 17 individuals...Adverse events including those that
affect the central nervous system, skin and musculoskeletal
systems, as well as elevated liver enzymes, all occurred in less
that 2% of patients prescribed levofloxacin during clinical
trials. The incidence of adverse effects
observed in our patients (100%) greatly exceeded that expected."
(PDF File) Adobe Reader Required (circa 2002)
Fluoroquinolones were the most commonly prescribed class of
antibiotics for adults in 2002
Substituting or adding fluoroquinolones to established first-line
antituberculous drug regimens gives no additional benefit
Antimicrobial Drug
Prescribing for Pneumonia in Ambulatory Care
Of note, fluoroquinolone use in the 18- to 44-year age group more
than doubled from 2000 to 2002 (14% to 30%).Among fluoroquinolones
prescribed over all years of the study, 74% were for levofloxacin; 51% of levofloxacin prescriptions were considered inappropriate-These
findings suggest that those prescribing antimicrobial drugs may be
increasingly using fluoroquinolones as a "one-size-fits-all"
regimen without accounting for differences due to age and other
risk factors
ODS
POSTMARKETING SAFETY REVIEW
Consult: One-Year Post Pediatric Exclusivity Postmarketing
Adverse Events Review Ciprofloxacin
NDA: 19-537, 19-847 PDF File
(In summary, in the 13-month period of review the
17 unique pediatric cases showed mostly labeled hematological,
musculoskeletal, allergic/hypersensitivity, and CNS events...
because one report was concerning due to the patient requiring a
wheelchair after developing drug associated symptoms...)
Switching Fluoroquinolones in Patients with Neutropenia May Increase
Infection Risks
The use of Factive (Gemifloxacin)
in elderly persons is not strongly recommended in light of the
associated risks and the fact that it does not offer any benefit over
other fluoroquinolones.
Yet another pediatric trial: Quinolones no better than standard
antibiotics when treating treating typhoid and
paratyphoid fever with Norfloxacin having more clinical failures than
other fluoroquinolones.
Avoiding Achilles tendon
ruptures in the elderly - Literature Monitor
Clinician Reviews, Oct, 2003
It has now been confirmed that quinolones, the most frequently
prescribed antibacterial agents, increase the risk of Achilles tendon
rupture in elderly patients, according to van der Linden et al
Fungal Infections Associated with
Ofloxacin. "An increase
in incidence of fungal infections of the ear were found in the period
after widespread use of ofloxacin began."
Antibiotic Treatment Does Not Reduce Risk of Secondary Cardiac Events
Fluoroquinolone prescribing in the United
States: 1995 to 2002.
Antibiotics not effective
for many coughs Medical Study News Published: Wednesday, 22-Jun-2005
FDA officials
called on Alcon to "cease the dissemination" of misleading information
regarding their antibiotic ear drops, called Cipro HC Otic., and told
company officials to respond to the
warning by May 11, 2005
August 2004, Moxifloxacin (Avelox) when
prescribed for Community Acquired Pneumonia, Chronic Bronchitis,
Acute Bacterial Sinusitis offers no compelling advantages over
established treatment. Claims that oral moxifloxacin provides
"rapid relief from chest infections" are unsubstantiated.
Of 100
total patients, 81 received an FQ for an inappropriate
indication. Of the 19 patients who received an FQ for an appropriate
indication, only 1 received both the correct dose and duration of
therapy. ( 1% received the appropriate drug
at the appropriate dose, hence 99% of the prescriptions were in error)
Antibiotic treatment does not
help sore throats. British Medical Journal N0 7104 Volume 315, August 9,
1997
Antibiotic use in treating bronchitis is unnecessary and risky
The Journal of Family Practice 1997;44(3):261-265
Antibiotics
useless on cold viruses, the uncontrolled and inappropriate use of
antibiotics.
The overuse of
antibiotic such as happened with children suffering from otitis media
has given rise to a breed of super bacteria which are resistant to
antibiotics entirely.
Source: "Antimicrobials for acute otistis media; A review from the
International Primary Care Network". British Medical Journal July 5,
1997. "Penicillin resistant streptococcus pneumoniae found in
chronic otitis media with effusion." American Academy of
Otolaryngology Sept. 2, 1997
(Seven years later the FDA has
approved Clinical Trials for the Pediatric use of fluoroquinolones to
treat Otitis Media in children as young as six months old)
Antibiotics'
Futility Against Bronchitis Confirmed
Combining the Gonzales and Evans study we
find about 24 million prescriptions for an antibiotic in which 90%
(21.6 million patients) would receive no greater benefit than if they
had taken vitamin C.
Cipro, Related Antibiotics Over-Prescribed...A new study heightens
concerns that Cipro and related broad-spectrum antibiotics known as
fluoroquinolones are being over-prescribed...
Gatifloxacin and moxifloxacin have no proven
clinical advantages over other fluoroquinolones, macrolides, or amoxicillin