Fluoroquinolones Health Article

Definition

Fluoroquinolones are medicines that kill bacteria or prevent their growth.

Purpose

Fluoroquinolones are antibiotics, medicines used to treat infections caused by microorganisms. Physicians prescribe these drugs for bacterial infections in many parts of the body. For example, they are used to treat bone and joint infections, skin infections, urinary tract infections, inflammation of the prostate, serious ear infections, bronchitis, pneumonia, tuberculosis, some sexually transmitted diseases (STD), and some infections that affect people with AIDS.

Description

Fluoroquinolones are available only with a physician's prescription and are sold in tablet and injectable forms. Examples of these medicines are moxifloxacin (Avelox), ciprofloxacin (Cipro), ofloxacin (Floxin), levofloxacin (Levaquin), lomefloxacin (Maxaquin), norfloxacin (Noroxin), enoxacin (Penetrex), gatifloxacin (Tequin), and sparfloxacin (Zagam).

Recommended dosage

The recommended dosage depends on the type and strength of fluoroquinolone, and the kind of infection for which it is being taken. Check with the physician who prescribed the drug or the pharmacist who filled the prescription for the correct dosage.

To make sure the infection clears up completely, take the medicine for as long as it has been prescribed. Do not stop taking the drug just because symptoms begin to improve. Symptoms may return if the drug is stopped too soon.

Fluoroquinolones work best when they are at constant levels in the blood. To help keep levels constant, take the medicine in doses spaced evenly through the day and night. Do not miss any doses. For best results, take this medicine with a full glass of water and drink several more glasses throughout the day, every day during treatment with the drug. The extra water will help prevent some side effects. Some fluoroquinolones should be taken on an empty stomach; others may be taken with meals. Check package directions or ask the physician or pharmacist for instructions on how to take the medicine.

Precautions

Research suggests that fluoroquinolones may cause bone development problems in children and teenagers. Infants, children, teenagers, pregnant women, and women who are breastfeeding should not take this medicine unless directed to do so by a physician.

Although such side effects are rare, some people have had severe and life-threatening reactions to fluoroquinolones. Call a physician immediately if any of these signs of a dangerous reaction occur:

• swelling of the face and throat
• swallowing problems
• shortness of breath
• rapid heartbeat
• tingling of fingers or toes
• itching or hives
• loss of consciousness

Some fluoroquinolones may weaken the tendons in the shoulder, hand, or heel, making the tendons more likely to tear. Anyone who notices pain or inflammation in these or other tendon areas should stop taking the medicine immediately and call a physician. Rest and avoid exercise until the physician determines whether the tendons are damaged. If the tendons are torn, surgery may be necessary to repair them.

These medicines make some people feel drowsy, dizzy, lightheaded, or less alert. Anyone who takes these drugs should not drive, use machines or do anything else that might be dangerous until they have found out how the drugs affect them.

This medicine may increase sensitivity to sunlight. Even brief exposure to sun can cause a severe sunburn or a rash. While being treated with fluoroquinolones, avoid being in direct sunlight, especially between 10 A.M. and 3 P.M.; wear a hat and tightly woven clothing that covers the arms and legs; use a sunscreen with a skin protection factor (SPF) of at least 15; protect the lips with a sun block lipstick; and do not use tanning beds, tanning booths, or sunlamps.

Do not take antacids that contain aluminum, calcium, or magnesium at the same time as fluoroquinolones. The antacids may keep the fluoroquinolones from working as they should. If antacids are needed, take them at least two hours before or two hours after taking norfloxacin or ofloxacin, at least four hours before or two hours after taking ciprofloxacin. Follow the same instructions for taking sucralfate (Carafate), a medicine used to treat stomach ulcers and other irritation in the digestive tract and mouth.

Anyone who has had unusual reactions to fluoroquinolones or related medicines such as cinoxacin (Cinobac) or nalidixic acid (NegGram) in the past should let his or her physician know before taking the drugs again. The physician should also be told about any allergies to foods, dyes, preservatives, or other substances.

Before using fluoroquinolones, people with any of these medical problems should make sure their physicians are aware of their conditions:

• kidney disease
• liver disease with kidney disease
• diseases of the brain or spinal cord, including hardening of the arteries in the brain, epilepsy, and other seizure disorders

Taking fluoroquinolones with certain other drugs may affect the way the drugs work or may increase the chance of side effects.