Understanding the risks
The Food and Drug Association (FDA) of the United States has recently issued a warning that taking certain antibiotics increase the risk of having an aortic aneurysm. This class of antibiotics, the fluoroquinolones, have been found to double a person’s risk of having an aortic aneurysm based on four recently published studies and adverse events reporting.
“Although the risk of aortic aneurysm or dissection is low, we’ve observed that patients are twice as likely to experience an aortic aneurysm or dissection when prescribed a fluoroquinolone drug,” said FDA commissioner Scott Gottlieb, MD.
An aortic aneurysm is a serious health condition which involves stretching, enlarging and potentially tearing of the largest artery of the body, the aorta. Aortic aneurysms occur in 1.4 per cent of the United States population according to the Aneurysm Detection and Management study from 1997. While many people with stretching of their aorta will never have any health problems as a result, some can have tearing and potentially fatal bleeding.
Fluoroquinolones are a class of broad spectrum antibiotics, which are often used to treat urinary tract infections when other drugs can’t be used or have failed to treat the infection. Fluoroquinolone antibiotics are very rarely used in children because of their potential to cause significant connective tissue prob- lems in children.
There have also been multiple warnings issued by the FDA regarding fluoroquinolones over the past decade including about their potential to decrease blood sugar, elicit mental health side effects, peripheral neuropathy and dis- abling side effects of the tendons, muscles, joints, nerves and central nervous system.
While the FDA maintains that there is certainly still a place for fluoroquinolone antibiotics in medicine, their use should be restricted in those at increased risk of an aortic aneurysm.
“For patients who have an aortic aneurysm or are known to be at risk of an aortic aneurysm, we do not believe the benefits outweigh this risk, and alternative treatment should be considered.”
The people at higher risk of having an aortic aneurysm include those with a family history of the condition, smokers, people with high blood pressure and those with disease of the heart and vessels. Marfan syndrome and Ehlers-danlos syndrome are two genetic conditions which affect connective tissue health and increase the risk of aortic aneurysm.
At the time of writing, Health Canada has not released an official warning regarding the increased risk of aortic aneurysm with the use of fluoroquinolone medications. In July 2018, Health Canada released a warning about the disabling effect of fluoroquinolones on connective tissues, similar to the one released by the FDA in the USA.
More can be learned about this warning from the FDA by visiting their website at fda.gov/ Drugs/drugsafety.
There have been multiple warnings issued by the FDA regarding fluoroquinolones over the past decade including about their potential to decrease blood sugar, elicit mental health side effects, peripheral neuropathy and disabling side effects of the tendons, muscles, joints, nerves and central nervous system.