A New Criterion for Fluoroquinolone-Associated Disability Diagnosis: Functional Gastrointestinal Disorders

• Published in: Medicina (Kaunas, Lithuania) Vol. 57; no. 12; p. 1371
• Main Authors: Cannizzaro, Deanna N, Naughton, Lydia F, Freeman, Maya Z, Martin, Linda, Bennett, Charles L, Bove, Cecilia
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 16-12-2021; MDPI
• Subjects: adverse drug reaction; Anti-Bacterial Agents - therapeutic use; Antibiotics; Bacterial Infections; Clinical trials; Convulsions & seizures; Data analysis; Discriminant analysis; Drug dosages; fluoroquinolone associated disability; fluoroquinolones; Fluoroquinolones - adverse effects; functional gastrointestinal disorder; Gastrointestinal Diseases - chemically induced; Gastrointestinal Diseases - diagnosis; Gram-positive bacteria; Humans; Infections; Irritable bowel syndrome; Motility; Nervous system; Questionnaires; Social networks; Surveys and Questionnaires; Urogenital system; United Kingdom > UK; United States > US; Italy; functional gastrointestinal disorder; fluoroquinolone associated disability; fluoroquinolones; adverse drug reaction
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina57121371

Fluoroquinolones (FQs) are a broad-spectrum class of antibiotics routinely prescribed for common bacterial infections despite recent recommendations to use them only for life-threatening cases. In addition to their antimicrobial properties, FQs act in the central nervous system as GABA
receptor inhibitors, which could potentially affect functionality of the vagus nerve at the forefront of gastrointestinal (GI) tract function. Alterations in neural control of digestion have been shown to be linked to Functional Gastrointestinal Disorders (FGIDs), which are usually diagnosed based on self-reported symptoms. The aim of this study was to assess the incidence of FGIDs following FQ use.
: Self-reports from the FDA Adverse Event Reporting System were analyzed together with ~300 survey responses from a social network derived sample to the Bowel Disease Questionnaire.
The results of this study suggested that six different FQs are associated with a wide range of GI symptoms not currently reported in the drugs' labels. The responses from the survey suggested that ~70% of FQ users scored positive for FGID, with no positive correlation between drug type, duration of administration, dosage and frequency of administration.
: This study showed that GI disorders other than nausea, vomiting and diarrhea are more common than currently reported on the drug labels, and that FGIDs are possibly a common consequence of FQ use even after single use.