Fluoroquinolones and the questions

An abstract from http://www.medpagetoday.com/InfectiousDisease/GeneralInfectiousDisease/54528

” Data on the risks and benefits of the drugs do not support their use in acute bacterial sinusitis, acute bacterial exacerbation of chronic bronchitis in patients with COPD, or uncomplicated urinary tract infections, members of the Antimicrobial Drugs Advisory Committee and the Drug Safety and Risk Management Advisory Committee in joint session agreed.

The 21-member panel, often interrupted by applause from the gallery during the voting, voted unanimously that support for fluoroquinolone use in acute bacterial sinusitis was lacking. On the bronchitis/COPD indication, the panel voted 18-2, with one abstention, that evidence was insufficient. And for uncomplicated urinary tract infections, the vote was 20-1…”

“…Panel members were disturbed by suggestions that the fluoroquinolones are being used inappropriately and urged that new labeling should emphasize that they should only be given in the three indications as second-line therapy.
“Risk-benefit here is mediated by the fact that current guidelines are not necessarily followed,” commented Almut Winterstein, PhD, of the University of Florida in Gainesville.
She added that there is “sufficient evidence” of a treatment benefit with fluoroquinolones in all three indications, but only when first-line therapies have failed.
Many also urged the FDA to make warnings about the possible side effects more prominent to ensure that both doctors and patients are aware of the risks.”

Bottom line: DO NOT use FQs as first line in acute sinusitis, bacterial exacerbation of chronic bronchitis and uncomplicated UTI.

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