Fluoroquinolone Antibiotics Can Lead To Heart Problems

Fluoroquinolone antibiotics can lead to heart problems

For the first time, Canadian scientists have shown a link between two types of heart problems and one of the most commonly prescribed classes of antibiotics, fluoroquinolones.

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The use of fluoroquinolone antibiotics 2.4 times increases the risk of developing aortic and mitral regurgitation (reverse blood flow to the heart) compared with taking a different class of antibiotic - amoxicillin, researchers from the University of British Columbia found. The results are published in the Journal of the American College of Cardiology.

Recent studies, which we wrote about earlier, also link the use of fluoroquinolones with the occurrence of cardiovascular problems - aortic dissection.

Some doctors prefer fluoroquinolones (such as ciprofloxacin) over other classes of antibiotics because of their broad spectrum of antibacterial activity and high oral absorption, as effective as intravenous treatment.

“You can send patients home with a once-daily pill. This class of antibiotics is very convenient, but for most cases, especially for domestic infections, they are not really needed. Misuse can cause both antibiotic resistance and serious heart problems,”said Mahyar Etminan, lead author of the study.

The researchers analyzed two sources - the FDA's Adverse Event Reporting System and the US Private Insurance Benefit Database (including demographics, drug identification, prescribed dose and duration of treatment). They compared the use of different groups of antibiotics - fluoroquinolones, amoxicillin and azithromycin.

The investigators identified 12,505 cases of valvular regurgitation among 125,020 control patients in a randomly representative sample. They identified three time intervals for drug intake:

current exposure - active prescription or 30 days before the adverse event,

• recent exposure 31 to 60 days;
• past exposure - from 61 to 365 days.

The results have shown that the risk of aortic and mitral regurgitation is highest with current drug use, followed by recent use. The use of this class of antibiotics in the past is at risk.

The results of the study, according to the authors, inform the public and doctors that if no other cause of heart disease is found in patients, the cause may be precisely antibiotics of the fluoroquinolone class.

“This study highlights the need for thoughtful prescribing antibiotics, which can sometimes be harmful,” said Bruce Carleton, director of research at Children's Hospital, British Columbia.

Scientists hope the findings may prompt doctors to use other classes of antibiotics as a first line of defense against uncomplicated infections.