FDA: Fluoroquinolones Tied to Increased Risk for Aortic Dissection, Aneurysm

By Amy Orciari Herman

Edited by Lorenzo Di Francesco, MD, FACP, FHM

Fluoroquinolone antibiotics are associated with increased risk for aortic dissection and aneurysm, the FDA has warned. The caution, based on a review of cases reported to the agency plus four observational studies, applies to all systemic fluoroquinolones.

The FDA said that while there are limitations to the data, the evidence "appears to be consistent across multiple epidemiological studies showing an approximately two-fold increased risk over the baseline risk of aortic aneurysm or dissection in each study."

The FDA offers the following advice for clinicians:

• Do not prescribe fluoroquinolones to patients with, or at risk for, an aortic aneurysm — unless there are no other options. Such patients include older adults and those with peripheral atherosclerotic vascular disease, hypertension, Marfan syndrome, and Ehlers-Danlos syndrome.

• Tell all patients to seek immediate medical attention if they develop symptoms of aortic aneurysm.

• Stop fluoroquinolones right away if patients have symptoms of aortic aneurysm or dissection.