Canadian researchers are warning expectant mothers to avoid antibiotics like Levaquin, Cipro and Avelox, after their study suggested that fluoroquinolones were among those most strongly associated with an increased risk of birth defects when used during the first trimester of pregnancy.
The study, which was published this week in the British Journal of Clinical Pharmacology, tracked nearly 140,000 mothers whose babies were born in Quebec from 1998 to 2008. The authors of the paper looked at their antibiotic use during the 1st trimester of pregnancy, as well as their babies’ birth defects through the first year of life.
Clindamycin, doxycycline, quinolones, macrolides and phenoxymethylpenicillin were linked to congenital malformations. No association was seen with amoxicillin, nitrofurantoin and cephalosporins.
The senior author of the study told The New York Times that quinolones, a class that includes Levaquin and other fluoroquinolone antibiotics, appeared to be the most dangerous and should be avoided during pregnancy.
Fluoroquinolone like Levaquin, Cipro and Avelox0 are prescribed to millions of people every year to treat pneumonia and other bacterial infections. However, this study is not the first time the drugs have been linked to serious safety concerns.
In May 2016, the U.S. Food & Drug Administration (FDA) warned that fluoroquinolone antibiotics should not be used to treat sinusitis, bronchitis and uncomplicated UTIs when other options are available, as their risks generally outweigh their benefits. The warning followed an agency review that suggested fluoroquinolones could cause multiple and permanent side effects involving the tendons, muscles, joints, nerves and central nervous system.
In August 2013, the FDA ordered the drugs’ manufacturers to update the prescribing information regarding their potential association with a serious and often permanent form of nerve damage called peripheral neuropathy. While mention of the condition had been added to fluoroquinolone labels in 2004, the agency determined that the prescribing information did not reflect the possible rapid onset of the condition, or the potential for permanent nerve damage.
In October 2015, research that appeared in JAMA Internal Medicine suggested that fluoroquinolone antibiotics were associated with an approximately 2-fold increase in the risk of aortic dissection and aneurysm within 60 days of exposure. The authors of the study suggested that collagen degradation could also be the mechanism behind the aortic injuries observed in some fluoroquinolone patients.
Hundreds of lawsuits involving Levaquin, Cipro and Avelox are currently pending in the U.S. District Court, District of Minnesota, all of which were filed on behalf of individuals who allegedly developed peripheral neuropathy related to fluoroquinolone treatment. The proceeding’s first trials are expected to get underway in the Fall of 2018.