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Drugs & treatments

AIFA restricts the use of antibiotics which contain fluoroquinolones

June 26, 2019

A brake on the abuse of antibiotics that contain fluoroquinolones: ciprofloxacin – levofloxacin – moxifloxacin – pefloxacin – prulifloxacin – rufloxacin – norfloxacin – lomefloxacin. This is the sense of the note issued by the Italian Medicines Agency (AIFA) that has called for great caution in prescribing these drugs for less serious infections also pointing to a safety problem: this is the case of the family of fluoroquinolones, often prescribed for the treatment of infections of the urinary and early respiratory tract. We talked about it with Dr. Maria Fazio, head of Humanitas Pharmacy.


Antibiotics with fluoroquinolones, AIFA re-evaluates their benefits

AIFA, in its note, has asked that several antibiotics belonging to the families of quinolones and fluorquinolones should be prescribed with great caution because they can induce, besides reactions to the musculoskeletal system and the nervous system, the appearance of serious diseases of the aorta.

As a result, the benefits and risks of all quinolone and fluoroquinolone antibiotics and their indications in EU countries have been reassessed. The Agency has therefore decided to withdraw from the market medicinal products containing cynoxacin, flumechin, nalidixic acid and pipemidic acid with a mechanism of action similar to that of fluoroquinolones. A decision taken after epidemiological studies showed an increased risk of aneurysm and aorta dissection in the patients who were exposed to treatment with fluoroquinolones. The suggestion is not to use these drugs for mild infections that would heal even without antibiotics or that may respond to other antibiotics.

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From the Agency to the general practitioner

Many of the active ingredients mentioned in the AIFA note have been widely used for decades for the treatment of cystitis and bronchitis. Not surprisingly, the Agency has invited all prescribing physicians to avoid using these drugs to treat minor infections such as pharyngitis, tonsillitis and acute bronchitis, and for mild to moderate infections including uncomplicated cystitis. AIFA also invites physicians to evaluate very carefully the antibiotic-based drug therapy they intend to prescribe: the increase in resistance (the phenomenon whereby bacteria resist those antibiotics that once were able to defeat them), favored by inappropriate consumption and abuse, is a major problem worldwide.

The reporting of suspected adverse reactions occurring after the authorization of the medicinal product is very important, as it allows continuous monitoring of the benefit/risk ratio of the medicinal product. All citizens, in addition to health professionals, are invited to report any problems that may occur after taking a medicine, with the aim of increasing the safety of the drugs in use.

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