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氟喹诺酮类药物:临床实践中的神经并发症及副作用

Fluoroquinolones: Neurological Complications and Side Effects in Clinical Practice.

作者信息

Anwar Ahmed I, Lu Lei, Plaisance Connor J, Daniel Charles P, Flanagan Chelsi J, Wenger Danielle M, McGregor David, Varrassi Giustino, Kaye Adam M, Ahmadzadeh Shahab, Cornett Elyse M, Shekoohi Sahar, Kaye Alan D

机构信息

Psychology, Quinnipiac University, Hamden, USA.

Neurology, Medical University of South Carolina, Charleston, USA.

出版信息

Cureus. 2024 Feb 20;16(2):e54565. doi: 10.7759/cureus.54565. eCollection 2024 Feb.

Abstract

Fluoroquinolones, a popular antibiotic class that inhibits nucleic acid synthesis of bacteria by disrupting the activity of the enzyme's topoisomerase IV and DNA gyrase, are used to treat bacterial infections. However, the widespread use of these drugs has allowed for the development of microbial resistance in recent years. Quinolones also have many clinically relevant side effects, including psychosis, confusion, seizures, headaches, dizziness, and nausea. Common side effects include tendinitis, myopathy, depression, and fatigue. Cardiovascular side effects include increased risk of aortic aneurysm, aortic dissection, and QT interval prolongation. Overall, quinolones can be an effective choice for treating bacterial infections. Still, the side effect profile and decreased efficacy secondary to microbial resistance no longer make the quinolone class an ideal choice for many types of infection. A better understanding of the role of quinolone-mediated or neurological damage, cardiovascular impairment, and musculoskeletal involvement is imperative to determine the risks/benefits for the clinician.

摘要

氟喹诺酮类是一类常用的抗生素,通过破坏拓扑异构酶IV和DNA旋转酶的活性来抑制细菌核酸合成,用于治疗细菌感染。然而,近年来这些药物的广泛使用导致了微生物耐药性的产生。喹诺酮类药物也有许多临床相关的副作用,包括精神病、意识模糊、癫痫发作、头痛、头晕和恶心。常见副作用包括肌腱炎、肌病、抑郁和疲劳。心血管副作用包括主动脉瘤、主动脉夹层和QT间期延长的风险增加。总体而言,喹诺酮类药物可以是治疗细菌感染的有效选择。不过,副作用情况以及微生物耐药性导致的疗效下降,使得喹诺酮类药物不再是许多类型感染的理想选择。更好地了解喹诺酮介导的神经损伤、心血管损害和肌肉骨骼受累的作用,对于临床医生确定风险/益处至关重要。

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