Fluoroquinolones Are Too Risky for Common Infections

http://www.consumerreports.org/drugs/fluoroquinolones-are-too-risky-for-common-infections/

By Teresa Carr
Last updated: May 16, 2016

The Food and Drug Administration (FDA) is advising against prescribing fluoroquinolones, a group of antibiotics that includes drugs such as Cipro and Levaquin, to treat three common illnesses —bronchitis, sinus infections, and urinary tract infections. The agency issued the new recommendations after a safety review revealed that fluoroquinolones can cause disabling and potentially permanent side effects that affect the tendons, muscles, joints, nerves, and central nervous system.

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Currently, those three illnesses account for nearly one-third of all fluoroquinolones prescribed outside of hospitals in the U.S. according to data presented by Janssen Pharmaceuticals, makers of Levaquin, at the FDA meeting. That overprescribing of the potent antibiotics is exposing patients to needless risk the panel concluded. While fluoroquinolones are essential for treating serious infections such as anthrax, for more common infections, other treatments typically work just as well with less risk.

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The new FDA ruling calling for restricted use of fluoroquinolones affects five prescription antibiotics: ciprofloxacin (Cipro), levofloxacin (Levaquin), moxifloxacin (Avelox), ofloxacin (Floxin), and gemifloxacin (Factive). All are also available as generics.

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“The vast majority of sinus infections are caused by a virus, not a bacteria and antibiotics don’t work against viruses,” says Baden. Even if bacteria are responsible, the infection will typically clear up on its own in a week or so. An antibiotic such as amoxicillin may be warranted if your symptoms last longer than a week, start to improve and then worsen, or are very severe—accompanied by a fever of 101.5 or higher, for example, or extreme pain and tenderness over your sinuses.

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Note that people aged 65 and older often have bacteria in their urine, but do not need to be tested or treated for a UTI unless they have symptoms.

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As with sinus infections, most cases of bronchitis, or chest colds, are caused by a virus and are not helped by taking an antibiotic. (Read our advice on what to do ease symptoms while your body fights the infection.) One exception: patients with chronic obstructive pulmonary disease (COPD), a condition that causes difficulty breathing, may benefit from antibiotics if they develop symptoms severe enough to require hospitalization.

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