Infectious Disease Compendium


Ciprofloxacin, sparfloxacin.

These are considered respiratory quinolones: levofloxacin (at the 750 mg dose), moxifloxacin, gemifloxacin.

Quinolones. What is it about quinolones? People do love to give quinolones. And they are great drugs but there is the whole issue of toxicity.

They drive of C. difficile and MRSA. They cause qt prolongation and drug-drug interactions with fluconazole and other drugs.

Quinolones really mess with connective tissues. Everyone, or at least everyone who matters, know quinolones are associated with tendon rupture. But there is AAA rupture, retinal detachment, carpal tunnel (PubMed), delayed healing of bone, and slowed cornea healing.

The FDA says to avoid them for uncomplicated infections (PubMed).

... advising that fluoroquinolones should be reserved for these conditions only when there are no other options available due to potentially permanent, disabling side effects occurring together.

I try and avoid them for complicated infections as well. If I can.

Last update 11/30/19