SA medicines regulator warns about side effects of antibiotics

SA's medicines regulator has warned patients of disabling and potentially permanent side effects associated with quinolone and fluoroquinolone antibiotics, and urged people taking these medicines to consult their doctors on whether to continue using them.

Quinolone and fluoroquinolones are broad-spectrum antibiotics that are widely used in SA, particularly in the private sector. They are frequently prescribed for respiratory and urinary tract infections, as well as more severe conditions.

New safety information indicated a small percentage of patients could experience severe side effects lasting months or years after they stopped taking the drugs, said the South African Health Products Regulatory Authority (Sahpra). The side effects include problems with muscles, joints, tendons and the nervous system. As a result, the use of these antibiotics has been changed, it said.

Quinolone and fluroquinolone antibiotics registered in SA include nalidixic acid, pipemidic acid, ciprofloxacin, ofloxacin, moxifloxacin, gemifloxacin, norfloxacin and levofloxacin. They are manufactured and sold by a large number of pharmaceutical companies. Ciprofloxacin is often used to treat urinary tract infections, while moxifloxacin is used for tuberculosis.

There was growing evidence that the risks associated with quinolone and fluoroquinolone drugs outweighed their benefits for uncomplicated infections that could be treated with other antibiotics such as penicillins, said Marc Blockman, a clinical pharmacologist at the University of Cape Town. Quinolone and fluoroquinolone antibiotics had unfortunately become “go to” drugs for infections such as bronchitis and urinary tract infections, he said.

However, these antibiotics still had a role to play in treating potentially life-threatening cases, such as deep-seated infections where there was a risk of organ failure, he said.

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