Skip to main content
SpringerLink
Log in

Fluoroquinolone Toxicities

An Update

  • State-Of-The-Art Presentations
  • Published:
Drugs Aims and scope Submit manuscript

Summary

The main types of adverse effects associated with quinolones are uncommon and reversible and vary in frequency among different agents. Phototoxicity appears more frequent with lomefloxacin than with some other quinolones. Three mechanisms have been proposed to explain the neurotoxic effects, including rare proconvulsant activity, associated with quinolone therapy. Arthropathy remains a dilemma for paediatricians deciding whether to use quinolones in growing children. Importantly, the experience with temafloxacin, which has now been withdrawn from the market, emphasises the need for thorough postmarketing surveillance. Nonetheless, it should be remembered that the fluoroquinolones as a group are effective and very well tolerated antimicrobial drugs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Blum MD, Graham DJ, McClosley CA. Temafloxacin syndrome: review of 95 cases. Clin Infect Dis 1994; 18: 946–50

    Article  PubMed  CAS  Google Scholar 

  2. Norrby SR, Lietman PL. Safety and tolerability of fluoroquinolones. Drugs 1993; 45 Suppl. 3: 59–64

    Article  PubMed  Google Scholar 

  3. Deamer RL, Prichard JG, Koenker N, et al. Temafloxacin-induced hemolytic anemia and renal failure. Clin Pharm 1993; 12: 380–2

    PubMed  CAS  Google Scholar 

  4. Ray WA, Griffin MR, Avorn J. Evaluating drugs after their approval for clinical use. New Engl J Med 1993; 329 (27): 2029–32

    Article  PubMed  CAS  Google Scholar 

  5. Neringer R, Forsgren A, Hansson C. Lomefloxacin versus norfloxacin in the treatment of uncomplicated urinary tract infections: three-day versus seven-day treatment. Scand J Infect Dis 1992; 24: 773–80

    Article  PubMed  CAS  Google Scholar 

  6. Iravani A. Efficacy of lomefloxacin as compared to norfloxacin in the treatment of uncomplicated urinary tract infections in adults. Am J Med 1992; 92 Suppl. 4A: 75–81S

    Article  Google Scholar 

  7. Marutani K, Matsumoto M, Otabe Y, et al. Reduced phototoxicity of a fluoroquinolone antibacterial agent with a methoxy group at the 8 position in mice irradiated with long-wavelength UV light. Antimicrob Agents Chemother 1993; 37 (10): 2217–23

    Article  PubMed  CAS  Google Scholar 

  8. Matsumoto M, Kojima K, Nagano N, et al. Photostability and biological activity of fluoroquinolones substituted at the 8 position after UV irradiation. Antimicrob Agents Chemother 1992; 36 (8): 1715–9

    Article  PubMed  CAS  Google Scholar 

  9. Hagen SE, Domagala JM, Gracheck J, et al. Synthesis and antibacterial activity of new quinolones containing a 7-[3-(1-amino-1-methylethyl)-1-pyrrolidinyl] moeity. Gram-positive agents with excellent oral activity and low side-effect potential. J Med Chem 1994; 37: 733–8

    Article  PubMed  CAS  Google Scholar 

  10. Domagala JM, Hagen SE, Joannides T, et al. Quinolone anti-bacterials containing the new 7-[3-(1-aminoethyl)-1-pyrrolidinyl] side chain: the effects of the 1-aminoethyl moeity and its stereochemical configurations on potency and in vivo efficacy. J Med Chem 1993; 36: 8711–82

    Article  Google Scholar 

  11. Halliwell RF, Davey PG, Lambert JJ. Antagonism of GABAA receptors by 4-quinolones. J Antimicrobial Chemother 1993; 31: 457–62

    Article  CAS  Google Scholar 

  12. Halliwell RP, Davey PG, Lambert JJ. The effects of quinolones and NSAIDs upon GABA-evoked currents recorded from rat dorsal root ganglion neurones. J Antimicrob Chemother 1991; 27: 209–18

    Article  PubMed  CAS  Google Scholar 

  13. Davey PG, Charter M, Kelly S, et al. Ciprofloxacin and sparfloxacin penetration into human brain tissue and their activity as antagonists of GABAA receptor of rat vagus nerve. Antimicrob Agents Chemother 1994; 38: (6) 1356–62

    Article  PubMed  CAS  Google Scholar 

  14. DeSarro A, Zappala M, Chimirri A, et al. Quinolones potentiate cefazolin-induced seizures in DBA/2 mice. Antimicrob Agents Chemother 1993; 37 (7): 1497–503

    Article  CAS  Google Scholar 

  15. Dani>sovicová A, Krcméryová T, Belan S, et al. Magnetic resonance imaging in diagnosis of potential arthropathogenicity in children receiving quinolones: no evidence of quinolone-induced arthropathy. Drugs 1995; 49 Suppl. 2: 492–4

    Article  Google Scholar 

  16. Kubin R. Safety and efficacy of ciprofloxacin in paediatric parents [review]. Infection 1993; 21 (6): 413–21

    Article  PubMed  CAS  Google Scholar 

  17. Schroeder DJ, Hart LL, Lynch SS. Potential quinolone-induced cartilage toxicity in children. Ann Pharmacother 1994; 28: 336–8

    PubMed  Google Scholar 

  18. Hildebrand H, Kemplca G, Schluter G, et al. Chondrotoxicity of quinolones in vivo and in vitro. Arch Toxicol 1993; 67: 411–5

    Article  PubMed  CAS  Google Scholar 

  19. Takada S, Kato M, Takayama S. Comparison of lesions induced by intra-articular injections of quinolones and compounds damaging cartilage components in rat femoral condyles. J Toxicol Environ Health 1994; 42: 73–88

    Article  PubMed  CAS  Google Scholar 

  20. Hayem G, Pettit PX, Levacher M, et al. Cytofluorometric analysis of chondrotoxicity of fluoroquinolone antimicrobial agents. Antimicrob Agents Chemother 1994; 38 (2): 243–7

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Clinical Pharmacology, The Johns Hopkins University School of Medicine, 350 Building, 55 N. Broadway, Baltimore, Maryland, 21205, USA

    Paul S. Lietman

Authors
  1. Paul S. Lietman
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lietman, P.S. Fluoroquinolone Toxicities. Drugs 49 (Suppl 2), 159–163 (1995). https://doi.org/10.2165/00003495-199500492-00026

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003495-199500492-00026

Keywords

Search

Navigation