FDA Warns About Increased Risk of Ruptures or Tears in the Aorta Blood Vessel With Fluoroquinolone Antibiotics in Certain Patients

US Food and Drug Administration. December 20, 2018. Available at: https://www.fda.gov/Drugs/DrugSafety/ucm628753.htm (accessed 12/22/18).

A U.S. Food and Drug Administration (FDA) review found that fluoroquinolones can increase the occurrence of aortic aneurysm dissection or rupture. Cases and four published observational studies showed an increased risk of aortic aneurysm or dissection associated with fluoroquinolone use. The FDA advises prescribing fluoroquinolone antibiotics to patients who have an aortic aneurysm or are at risk for an aortic aneurysm, such as patients with peripheral atherosclerotic vascular diseases, hypertension, certain genetic conditions such as Marfan syndrome and Ehlers-Danlos syndrome, and elderly patients unless no other alternatives are available. The reports are not surprising since fluoroquinolones have been associated tendon inflammation and even rupture. Azithromycin and doxycycline have also rarely been reported to cause tendonitis and rupture but it is unclear whether caution should be used with these antibiotics in patients at risk for aortic dissection or rupture.