Clinical Safety Profile of Fluoroquinolones
Keith A Rodvold, Pharm D, FCP, FCCP
University of Illinois at Chicago, Colleges of Pharmacy and Medicine, USA
Fluoroquinolones are considered safe and well-tolerated anti-infective agents that are commonly used to treat community-acquired and healthcare-associated infections. The most frequent reported adverse events (e.g. gastrointestinal and central nervous system [CNS] reactions) are usually transient and mild to moderate in severity. However, serious adverse reactions have led to the withdrawal of temafloxacin and grepafloxacin from worldwide markets, and restrictive and limited use of trovafloxacin in the United States. Rare and agent-specific adverse events have included alterations in glucose homeostasis (e.g. gatifloxacin), prolongation of QTc interval (e.g. moxifloxacin), and skin rash (e.g. gemifloxacin). High-dose therapy for serious infections or short-course therapy has been limited to ciprofloxacin and levofloxacin secondary to their excellent tolerability and lower rates of adverse events compared to other, currently available, fluoroquinolones.