Abstract
In the last decade, several third and fourth generation fluoroquinolones (FQs) have been approved for clinical use. These new agents exhibit a more potent and broader-spectrum antibacterial activity and improved pharmacokinetic properties in comparison to the earlier FQs. Although new FQs are generally safe and well tolerated, moderate-to-severe toxicity events have been reported for some of them, leading to their restriction, suspension or even withdrawal from the market. The most common FQ-related adverse effects (AEs) are usually mild and involve the gastrointestinal tract (e.g. nausea and diarrhea) and the central nervous system (e.g. headache and dizziness). Uncommon, but severe AEs (e.g. arthropathy, QTc interval prolongation, dysglycaemia and phototoxicity) and idiosyncratic reactions (e.g. hepatitis and hemolytic anemia) have also been reported and will be discussed throughout this paper. The evidence currently available suggests that AEs can be inherent to the FQ class or can be associated with a particular chemical moiety of the molecular structure of each FQ, thus varying in frequency, severity and nature. The main goal of this review is to provide a systematic evaluation of safety and tolerability data of the newer FQs with emphasis on those currently marketed.
Keywords: Adverse effects, fluoroquinolones, structure-activity relationship, toxicity.
Current Drug Safety
Title:Third and Fourth Generation Fluoroquinolone Antibacterials: A Systematic Review of Safety and Toxicity Profiles
Volume: 9 Issue: 2
Author(s): Joana Sousa, Gilberto Alves, Ana Fortuna and Amilcar Falcao
Affiliation:
Keywords: Adverse effects, fluoroquinolones, structure-activity relationship, toxicity.
Abstract: In the last decade, several third and fourth generation fluoroquinolones (FQs) have been approved for clinical use. These new agents exhibit a more potent and broader-spectrum antibacterial activity and improved pharmacokinetic properties in comparison to the earlier FQs. Although new FQs are generally safe and well tolerated, moderate-to-severe toxicity events have been reported for some of them, leading to their restriction, suspension or even withdrawal from the market. The most common FQ-related adverse effects (AEs) are usually mild and involve the gastrointestinal tract (e.g. nausea and diarrhea) and the central nervous system (e.g. headache and dizziness). Uncommon, but severe AEs (e.g. arthropathy, QTc interval prolongation, dysglycaemia and phototoxicity) and idiosyncratic reactions (e.g. hepatitis and hemolytic anemia) have also been reported and will be discussed throughout this paper. The evidence currently available suggests that AEs can be inherent to the FQ class or can be associated with a particular chemical moiety of the molecular structure of each FQ, thus varying in frequency, severity and nature. The main goal of this review is to provide a systematic evaluation of safety and tolerability data of the newer FQs with emphasis on those currently marketed.
Export Options
About this article
Cite this article as:
Sousa Joana, Alves Gilberto, Fortuna Ana and Falcao Amilcar, Third and Fourth Generation Fluoroquinolone Antibacterials: A Systematic Review of Safety and Toxicity Profiles, Current Drug Safety 2014; 9 (2) . https://dx.doi.org/10.2174/1574886308666140106154754
DOI https://dx.doi.org/10.2174/1574886308666140106154754 |
Print ISSN 1574-8863 |
Publisher Name Bentham Science Publisher |
Online ISSN 2212-3911 |
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Cardiomyocyte-Specific TβR2 Knockout Mice are More Susceptible to Cardiac Hypertrophy Induced by Adrenergic Agonist Stimulation
Current Molecular Medicine Pro Atrial Natriuretic Peptide (1-30) and 6-keto PGF<sub>1α</sub> Activity Affects Na<sup>+</sup> Homeostasis in Non-modulating Hypertension
Current Hypertension Reviews The Endocannabinoid System: A Promising Target for the Management of Type 2 Diabetes
Current Protein & Peptide Science Editorial (Thematic Issue: The (Same Old) Problem of Uncontrolled Hypertension)
Current Hypertension Reviews Strict Adherence to Guidelines in Decision Making for Coronary Angiography in Patients Who have Survived a Q Wave Myocardial Infarction; 2-Year Outcome in a Greek Population
Vascular Disease Prevention (Discontinued) The Study of HFE Genotypes and Its Expression Effect on Iron Status of Iranian Haemochromatosis, Iron Deficiency Anemia Patients, Iron-Taker and Non Iron-Taker Controls
Recent Advances in DNA & Gene Sequences (Discontinued) Stroke Risk Stratification Schemes in Atrial Fibrillation in the Era of Non- Vitamin K Anticoagulants: Misleading and Obsolete, At Least for the “Low-Risk” Patients?
Current Drug Targets Biologically Responsive Nanosystems Targeting Cardiovascular Diseases
Current Drug Delivery Nanoparticles-Based Treatment for Bone Metastasis
Current Drug Targets Berberine as a Potential Multi-Target Agent for Metabolic Diseases: A Review of Investigations for Berberine
Endocrine, Metabolic & Immune Disorders - Drug Targets Vascular Effects of Insulin and Their Relation to Endothelial Dysfunction, Insulin Resistance and Hypertension
Current Hypertension Reviews Cardiovascular Disease Risk and Hormone Replacement Therapy (HRT): A Review Based on Randomised, Controlled Studies in Postmenopausal Women
Current Medicinal Chemistry Does Daily Dialysis Improve Hypertension in Chronic Haemodialysis Patients?
Current Hypertension Reviews HDL-Targeting Therapeutics: Past, Present and Future
Current Pharmaceutical Design Association of Selected Adipocytokines and Inflammatory Markers on Body Mass Index in Type 2 Diabetes Patients in Saudi Arabia and as Risk Factors to Cardiovascular Disease
Current Diabetes Reviews Intravascular Targeting of a New Anticoagulant Heparin Compound
Cardiovascular & Hematological Disorders-Drug Targets The Role of Inflammatory Biomarkers in the Detection and Therapy of Atherosclerotic Disease
Current Vascular Pharmacology Molecular Docking and Virtual Screening Based Prediction of Drugs for COVID-19
Combinatorial Chemistry & High Throughput Screening Regulation of Platelet Function by Acetylation/Deacetylation Mechanisms
Current Medicinal Chemistry Apolipoprotein A-I/HDL Infusion Therapy for Plaque Stabilization-Regression: A Novel Therapeutic Approach
Current Pharmaceutical Design