Re: C dif??? Quinolones ( Cipro, Levaquin, Avelox) most common cause of C dif

[Guest guest]

Clostridium difficile-associated

diarrhea: Although any antibiotic can

alter GI flora and allow for the overgrowth

of C. difficile, quinolones have

been incriminated in this increasingly

more common entity. Theoretically, because

these antibiotics have a good

anaerobic spectrum, they inhibit growth

of the more likable and normally protective

anaerobic flora in the gut. Quinolones

P a r t 1 i n a S e r i e s

Adverse Reactions to

Fluoroquinolones InFocus

Fluoroquinolones, such as ciprofloxacin (Cipro), levofloxacin

(Levaquin), and

moxifloxacin (Avelox) are generally safe and effective broad-spectrum

antibiotics.

They do, however, have their peccadilloes, and can cause some unusual

and

bothersome side effects that might not be readily associated with an

antibiotic.

Some adverse effects, such as acute CNS dysfunction, are seen while

the patient

is still taking the antibiotic. Others, such as tendinopathy, can

surface after the

drugs are stopped, when prior use does not make it to the now-

required medicine

reconciliation list. One would not usually attribute a malignant

ventricular

dysrhythmia, such as torsades, to an antibiotic, but the QTc

prolongation of

quinolones has this remote connection.

InFocus October 2008 ¡ EMN 17

kill those good guys with gusto, allowing

for the increased replication of normally

quiescent C. difficile. Quinolones are

probably the most common cause of C.

difficile of cases caused by antibiotics.

Ciprofloxacin appears to be more of a

culprit than levofloxacin, but this may be

a spurious data issue. Overall, however,

levofloxacin seems to have an edge of

safety with regard to C. difficile susceptibility.

The commonly used moxifloxacin

(Avelox), an antibiotic with significant

anaerobic activity, also has been thought

to be more likely to cause the overgrowth

of C. difficile than other antibiotics.

Comment: Emergency physicians see

these six conditions and symptoms in

many patients each day, and usually

there is no quinolone in sight.

>

>

>

> =============

>

> My son is in the icu in isolation because of pneumonia and c dif! I

wanted to ask all of you what you might know about it! I am the one

with psc not him but you all are so knowledgeable I thought you could

give me a idea what all this means! Cathy

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

> _________________________________________________________________

> Stay up to date on your PC, the Web, and your mobile phone with

Windows Live

> http://clk.atdmt.com/MRT/go/119462413/direct/01/

>