Everything You Need to Know.

What is a Fluoroquinolone?

A class of synthetic antibiotics approved/used to treat and prevent certain bacterial infections. They are of a group of fluorinated derivatives of quinolone. The sixth position controls the mechanism of action and bacterial potency of quinolones; they contain the fluorine atom at position number 6, bound to carbon, which creates the fluoroquinolone structure. This results in higher potency, better tissue penetration, greater bioavailability, and longer plasma half-life [28]. [30].

Fluoroquinolone antibiotics are [1]

1.       Ciprofloxacin (Cipro)

2.       Levofloxacin (Levaquin)

3.       Moxifloxacin (Avelox)

4.       Ofloxacin (Floxin and Ocuflox)

5.       Gemifloxacin (Factive)

6.       Norfloxacin (Noroxin) *

7.       Delafloxacin (Baxdela) *

There are four generations of fluoroquinolones, starting in the 1960’s [2] [19]. In 2008, the FDA released the first Black Box Warning for tendons and tendon ruptures.

As the years progressed, and more people were harmed by this class of antibiotics, additional Black Box Warnings were issued, including the introduction of Fluoroquinolone Associated Disability (FQAD) by the FDA in 2015.

Further Black Box Warnings were released for the worsening of Myasthenia Gravis (2011), potentially permanent peripheral neuropathy (2013), permanent and disabling side effects (2016), blood glucose disturbances (2018), psychiatric effects (2018), aorta tears and ruptures (2018).

As a result of the severity of fluoroquinolone adverse reactions, many have been discontinued due to the permanent and disabling effects [3].