Systemic Quinolones and Risk of Acute Liver Failure II: Systematic Review of Clinical Trials

Taher Mohamed Kadry,Mattison Donald,Bjerre Lise,Momoli Franco,Krewski Daniel,Habsah Mohamed

doi:10.23937/2378-3656/1410361

Abstract

Quinolones are a class with four generations of synthetic antibiotics characterized by a unique mechanism of action, broad spectrum, potent pharmacologic properties and reasonable safety profile. Their global and growing popularity has been accompanied by an increase in the emergence of antimicrobial resistance and occurrence of unexpected adverse reactions. Nevertheless, physicians continue to prescribe these drugs on an increasing scale, irrespective of the availability of other treatment alternatives.

Highlights

Quinolones are synthetic antibiotics that continue to gain popularity on a global scale since they were introduced in the mid-1960s (Table 1) [1]
One trial reported a single Acute liver failure (ALF) case with gemifloxacin and the other reported another case with moxifloxacin
Quinolone Antibiotic Nalidixic acid, cinoxacin, flumequine, oxolinic acid, piromidic acid, pipemidic acid, rosoxacin Lomefloxacin, norfloxacin, ciprofloxacin, ofloxacin, fleroxacin, pefloxacin, rufloxacin Levofloxacin, sparfloxacin, temafloxacin, grepafloxacin, balofloxacin, pazufloxacin, tosufloxacin Moxifloxacin, gemifloxacin, trovafloxacin, gatifloxacin, clinafloxacin, garenoxacin, sitafloxacin, prulifloxacin, finafloxacin quinolones as having a reasonable safety profile, with most adverse reactions being mild to moderate and self-limiting, some quinolones have been withdrawn from the market and others have sustained restricted usage advisories [8,9,10,11]

Summary

Introduction

Quinolones are synthetic antibiotics that continue to gain popularity on a global scale since they were introduced in the mid-1960s (Table 1) [1]. Acute liver failure (ALF) is a serious disease involving rapid, progressive and severe loss of hepatic cells without evidence of current or previous liver impairment [1214] While this loss is sometimes reversible, it is more likely to progress rapidly to patient death unless liver transplantation is carried out in a timely manner [1214]. Quinolones are a class with four generations of synthetic antibiotics characterized by a unique mechanism of action, broad spectrum, potent pharmacologic properties and reasonable safety profile. Their global and growing popularity has been accompanied by an increase in the emergence of antimicrobial resistance and occurrence of unexpected adverse reactions. Physicians continue to prescribe these drugs on an increasing scale, irrespective of the availability of other treatment alternatives

Methods

Results

Discussion

Conclusion