Research shows link between fluoroquinolone antibiotics and increased risk of aortic disease

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New research from a Swedish and Danish team of researchers led from Karolinska Institutet lend additional support to a link between treatment with fluoroquinolone antibiotics and an increased risk of acute aortic disease. The study is published in the esteemed journal The BMJ.

Fluoroquinolone antibiotics are used globally to treat a variety of infections. Recent observational studies have raised concerns that they may be associated with a more than twofold increase in the risk of acute and life-threatening aortic disease (aortic aneurysm or dissection). However, due to limitations in study design, it has not been possible to draw firm conclusions.

To assess whether there actually is a link, researchers from Karolinska Institutet and Lund University in Sweden and Statens Serum Institut in Denmark analysed data from Swedish national health registers. The researchers were then able to compare the risk of aortic aneurysm or dissection among more than 360,000 treatment episodes of fluoroquinolones with the risk among the same number of treatment episodes of amoxicillin, another type of antibiotic.

66 per cent increased risk

The results show a 66 per cent increase in the risk of aortic aneurysm or dissection in patients treated with fluoroquinolone antibiotics. This corresponded to an absolute difference of 82 cases per 1 million treatment courses with fluoroquinolone antibiotics.

"Our results confirm the findings in the previous studies but suggest that the increased risk is not as pronounced as indicated by those studies", says Björn Pasternak, associate professor at Karolinska Institutet's Department of Medicine, Solna, who led the study.

Like the previous ones, the current study is an observational study that is unable to prove a causal relationship. However, according to Björn Pasternak, because of its size and methodological design, it provides the most reliable results so far.

"Although the absolute risk increase was relatively small, the study's findings should be interpreted in the context of the widespread use of fluoroquinolones. Our overall objective is to help inform clinical practice through high-quality evidence".

Induce the activity of certain enzymes

The researchers also highlight a possible mechanism that might explain the association.

"One of the factors involved in the development of aortic disease is increased activity in tissue-degrading enzymes known as matrix metalloproteinases. We know that fluoroquinolones induce the activity of these enzymes, which is also thought to underlie the more well-known adverse effect of tendon pain and rupture", says Björn Pasternak.


  1. Mark A Girard Mark A Girard Canada says:

    FQs cause HORRIFIC devastation of every sort imaginable from head to toe, body and mind. The thing is, that with this class of drugs, the adverse reaction doesn't stop when the patient discontinues the drugs. Sadly, the victims tend to suffer a syndrome with a whole bunch of HORRIBLE "symptoms" that set in either all at once or in rapid succession. We end up have problems set in for years and years. I am pretty sure that these studies are measuring the increased likelihood of ruptures during the time that the person is taking the drugs, not a tracking of everyone who took them across time to see if they had one or a review of everyone who had one to see if FQs were in their medical histories. "The researchers were then able to compare the risk of aortic aneurysm or dissection among more than 360,000 treatment episodes of fluoroquinolones with the risk among the same number of treatment episodes of amoxicillin, another type of antibiotic." Again, I believe that by treatment episodes they are referring just to the time they are taking an FQ or perhaps also a short period afterward. The real number could be more like 20 times as likely, or 50 times as likely. All we know is it's much much higher than this. Also, it's not like most drugs that have one or two quirky ways they mess with people. FQs kill us in dozens of ways from plummeting blood pressure to soaring blood sugar, from collapsed lung to intracranial pressure, from muscle wasting to suicide, we are dropping like flies. Of course, in 99% or more of the cases, the cause of death listed is the diseases or condition the doctors suspected and not the combination of toxic chemicals the doctors prescribed. Dr. Charles Bennett of the University of South Carolina has estimated that FQs have killed roughly 300,000 Americans and millions globally. The number of Americans who have been sickened and maimed is in the tens of millions, the vast majority of whom are misdiagnosed, meaning not only that we do without treatment we need and suffer through additional toxic reactions as we take more drugs we don't need, but that we are padding the numbers of all sorts of different conditions such as lupus, fibro, ALS, Parkinsn's and so on. Not only are we boosting their numbers, but we are skewing their research and messing up their hopes for establishing efficacious best practices. This is a serious crisis of almost unimaginable scope and scale, the thalidomide story of our generation. You will be hearing a lot more about this soon...

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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