Clinical toxicological aspects of fluoroquinolones

Stahlmann, Ralf

doi:10.1016/s0378-4274(01)00509-4

Cited by 158 publications

(103 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although the rate of complications from antibiotic drug therapy was almost negligible in most studies, the choice of antibiotic drug influences unwanted side effects from treatment. Fluoroquinolones, for example, have been associated with QT prolongation [68,69], which renders these drugs not preferable in patients with stroke, who often suffer from cardiac comorbidity. Despite their excellent efficacy, broad antibacterial spectrum and good tolerability, cephalosporins, which rapidly induce drug-resistant bacteria, are arguably not the ideal drugs for preventive therapy [70,71].…”

Section: Discussionmentioning

confidence: 99%

Prophylactic Antibiotic Therapy for Preventing Poststroke Infection

Schwarz

2016

Neurotherapeutics

View full text Add to dashboard Cite

Infections, in particular pneumonia, are common complications in patients with acute stroke and are associated with a less favorable neurologic and functional outcome. Patients with severe stroke and dysphagia are at highest risk of infection. Experimental and clinical data suggest stroke-induced immunodeficiency as a major factor contributing to the high incidence of infection after stroke. Preclinical studies support the potential benefit of preventive antibiotic therapy in acute stroke for lowering the incidence of infection and improving clinical outcome. Several smaller clinical trials on preventive antibiotic therapy in patients with stroke conducted during the last 10 years yielded inconclusive results. Recently, 2 large, open-label, controlled trials failed to demonstrate an improved clinical outcome after preventive antibiotic therapy in patients with acute stroke treated in specialized stroke units. In the BPreventive Antibiotics in Stroke Study^, antibiotic therapy lowered the rate of infection but did not influence outcome. In the STROKE-INF study, performed in patients with dysphagia after stroke, antibiotic therapy did not lower the incidence of pneumonia and had no prognostic significance. At present, preventive antibiotic therapy cannot be recommended as a therapeutic option for acute stroke.

show abstract

Section: Discussionmentioning

confidence: 99%

Prophylactic Antibiotic Therapy for Preventing Poststroke Infection

Schwarz

2016

Neurotherapeutics

View full text Add to dashboard Cite

show abstract

“…It was known that there were some problems with the safety of fluoroquinolones such as renal dysfunction, liver dysfunction, QTc prolongation, abnormal glucose tolerance, photosensitivity, arthropathy and central nervous system disturbance [29] [30].…”

Section: Discussionmentioning

confidence: 99%

Garenoxacin Prophylaxis for Febrile Neutropenia after Chemotherapy in Hematological Malignancies

Nakamura¹,

Hara²,

Ninomiya³

et al. 2016

OJIM

View full text Add to dashboard Cite

Background: Febrile neutropenia is one of the most serious adverse events in patients with hematological malignancies and chemotherapy. The routine use of fluoroquinolone prophylaxis in patients with hematological malignancies is controversial. Therefore, we prospectively evaluated the efficacy and safety of prophylactic use of garenoxacin for febrile neutropenia. Patients and Methods: Consecutive adult patients with hematological malignancies who were at risk for chemotherapy-induced neutropenia lasting more than seven days were eligible for present study. They received oral garenoxacin (400 mg daily) from the neutrophil count decreased to less than 1000/μl and continued until the neutropenia had resolved. The primary endpoint was incidence of febrile neutropenia, and the secondary endpoints were the type and incidence of adverse events. Results: We enrolled 46 consecutive patients (median age, 59 years). The underlying diseases comprised acute myeloid leukemia (n = 17), acute lymphoblastic leukemia (n = 3), malignant lymphoma (n = 23), and multiple myeloma (n = 3). There were 23 febrile neutropenia episodes and 2 episodes of bacteremia. There were no grade 3 or 4 adverse events; however serum creatinine levels were significantly elevated after garenoxacin administration. The overall prophylactic efficacy of garenoxacin was 50%, and there were no infection-related deaths. Conclusions: Prophylactic use of garenoxacin is effective and safe in patients with hematological malignancies. (Clinical trial registration number: UMIN000004979).

show abstract

“…The reason why floroquinolones have been widely used in several infectious diseases is that they have high bioavailability and are known to be safe [3]. Nevertheless, neurotoxicity can also be observed after using these agents.…”

Section: Discussionmentioning

confidence: 99%