Sunday, February 20, 2011

I was curious about comparative study for ADRs between Fqs and other antibiotics. Those who are suffering from ADRs, (NOT allergic reactions), from other antibiotics, take note. So yes, many of us, have/had ADRs from non FQs post floxing!!

Aside the well known side effects of FQs, other antibiotics also cause damage to tendons, CNS symptoms and so forth.

"adverse effects for various fluoroquinolones was 3-40%. By comparison, these same studies reported adverse event rates of 2-49% for trimethoprim-sulfamethoxazole, 6-35% for penicillins, 12-39% for cephalosporins, 19-23% for doxycycline, and approximately 39% for erythromycin.[10,11]"

Abstract and Introduction

Extensive pharmacologic and clinical development of quinolone antimicrobial agents has resulted in improved antimicrobial activity, pharmacokinetic features, toxicity, and drug-drug interaction profiles. Nalidixic acid and other early quinolones had limited use due to poor pharmacokinetics, relatively narrow antimicrobial spectrum of activity, and frequent adverse effects. Beginning with the development of fluoroquinolones, such as norfloxacin and ciprofloxacin, in the 1980s, the agents assumed a greatly expanded clinical role because of their broad antimicrobial spectrum of action, improved pharmacokinetic properties, and more acceptable safety profile. Although the pharmacokinetics and efficacy of the drugs have improved significantly, a major area of continued emphasis is to further reduce the frequency and severity of adverse events and drug-drug interactions. Older agents such as ciprofloxacin and ofloxacin are still extensively prescribed, but the focus of this article is on the newer fluoroquinolones (levofloxacin and other drugs that have been approved or have been under investigation since approximately 1997).

Fluoroquinolones are considered to be safe and well tolerated,[1-4] although there are some notable exceptions, for example, temafloxacin, trova-floxacin, and, more recently, grepafloxacin.[5-9] This is especially true when fluoroquinolones are compared with other commonly prescribed antimicrobials.[3, 4] A review of safety results from numerous controlled clinical trials revealed that, overall, the agents are not significantly different from -- and in some cases were superior to -- nonquinolone comparators or placebo in occurrence of adverse events.[10, 11] Overall rates of adverse effects and rates of drug discontinuation from premarketing clinical studies of fluoro-quinolones are summarized in Table 1. [2-4,6,7,10-44]

Fluoroquinolones are generally highly comparable with other classes of antibiotics in terms of overall frequency and severity of adverse effects, although specific adverse effects vary among drug classes. In comparative clinical studies, the overall frequency of adverse effects for various fluoroquinolones was 3-40%. By comparison, these same studies reported adverse event rates of 2-49% for trimethoprim-sulfamethoxazole, 6-35% for penicillins, 12-39% for cephalosporins, 19-23% for doxycycline, and approximately 39% for erythromycin.[10,11]

True rates of adverse effects are often extremely difficult to determine. Comparative clinical studies may report two types of adverse events: treatment-emergent and drug-related. Treatment-emergent adverse effects are reported by study participants during the study. These are frequently quite subjective and are often not related to the study drug(s). Therefore, adverse event rates associated with administration of placebo are often as high as those associated with active agents. Treatment-emergent event rates also reflect adverse effects that are drug related. Although these rates are often much higher than the frequency of true drug-related adverse effects, they are reported because of difficulty determining causality. Drug-related adverse effect rates, when available, are usually much more useful with regard to agents of different classes as well as to those of the same class. Adverse effect rates of fluoroquinolones summarized in Table 1 include those that were reported to be possibly or probably drug related.

Most adverse events caused by fluoroquinolones are comparable, although overall frequency and manifestation of certain adverse effects differ among agents ( Table 2 ).[4,10] Each fluoroquinolone tends to produce a characteristic profile of adverse effects; differences often are explained by structural features and related relationships of the class.[45] The events are typically mild and usually resolve during continued treatment or with discontinuation of therapy, although early discontinuation for an event is unusual. Gastrointestinal effects (e.g., nausea, diarrhea) and central nervous system (CNS) effects (e.g., headache, dizziness) are most common. Toxic effects that are observed only in animal models or that have not been shown to be clinically relevant in humans include chondrotoxicity, reproductive and developmental toxicity, genotoxicity, and carcinogenicity.[2-4,10,11] Concerns regarding bone and joint toxicities in juvenile animal models thus far have precluded approval of fluoroquinolones for treatment of infections in children. However, more recent data indicate that the agents may be safe in this population, and this is being actively explored.

Read more:

No comments:

Post a Comment

List of some Fluoroquinolones Antibiotics

List of some fluoroquinolones antibiotics- for list of symptoms go to:

Generic & Brand Name of most common Fluoroquinolones

Brand Name: Trovan - Zithromax
Generic Name: Trovafloxacin and Azithromycin

Brand Name: Factive
Generic Name: Gemifloxacin Mesylate

Brand Name: Zagam
Generic Name: Sparfloxacin

Brand Name: Vigamox
Generic Name: Moxifloxacin

Brand Name: Vigamox
Generic Name: Moxifloxacin

Brand Name: Cinobac
Generic Name: Cinoxacin

Brand Name: Penetrex
Generic Name: Enoxacin

Brand Name: Tequin
Generic Name: Gatifloxacin (Removed from US Market - May 2006)

Brand Name: Levaquin
Generic Name: Levofloxacin

Brand Name: Floxin
Generic Name: Ofloxacin

Brand Name: Synercid
Generic Name: Quinupristin and Dalfopristin

Brand Name: Trovan - Zithromax

Brand Name: Zymar
Generic Name: Gatifloxacin Ophthalmic Solution

Brand Name: Avelox
Generic Name: Moxifloxacin HCL

Brand Name: Floxin Otic Singles

Brand Name: Ciprodex
Generic Name: Ciprofloxacin and Dexamethasone

Brand Name: Raxar
Generic Name: Grepafloxacin

Brand Name: Ocuflox
Generic Name: Ofloxacin Ophthalmic

Brand Name: Quixin
Generic Name: Levofloxacin

Brand Name: Cipro
Generic Name: Ciprofloxacin

Brand Name: Proquin XR
Generic Name: Ciprofloxacin Hcl

Brand Name: Requip XL
Generic Name: Ropinirole Extended Release Tablets

Brand Name: Zanaflex
Generic Name: Tizanidine

Brand Name: Noroxin
Generic Name: Norfloxacin

Brand Name: Maxaquin
Generic Name: Lomefloxacin Hcl

Brand Name: Ciloxan Ophthalmic Solution
Generic Name: Ciprofloxacin HCL Ophthalmic Solution

Brand Name: Cipro XR
Generic Name: Ciprofloxacin Extended-Release

Generic Name Norloaxin Brand Name: Noroxin

Generic Name Temafloxacin Brand name Omniflox