The US Food and Drug Administration (FDA) issued an important warning about a group of antibiotics. “Fluoroquinolone”, group of these drugs should be used with caution in risky patients even under doctor control because according to recent studies, these antibiotics can cause fatal aortic ruptures!
Antibiotics in infection therapy are still one of the best options in the medical world. However, without a doctor’s check, some antibiotics that are used without having any idea and even without having an antibiogram test can cause fatal symptoms such as aortic rupture in risky patients. Aortic aneurysm, which causes Oya Aydogan to lose her life, is a deadly disease that progresses insidiously without symptoms. Those who have the following symptoms are risky groups for aortic aneurysms; the ones who have high blood pressure, or who have someone in their families with high blood pressure, those who have high cholesterol, those who have sudden death cases in their families, those who have stroke or brain aneurysm related to the blood pressure, diabetes, fainting, and aortic insufficiency, etc. There is a need to be very careful when using antibiotics in these patients.
May cause fatal bleeding at all…
The American Food and Drug Administration (FDA) issued a serious warning on December 20 for the related patients and healthcare professionals. Accordingly they said that, the use of antibiotics with fluoroquinolone group commonly used in the treatment of lower respiratory tract infections such as urinary tract infections, bronchitis and pneumonia should be strictly restricted in risky patient groups and other medications should be preferred if possible. Because these drugs lead to a change in the DNA of the smooth muscle cell, causing the destruction of these muscles at the cell level. This may cause thinning, ballooning or even tearing of the aortic vessels, leading to fatal bleeding! Cardiovascular Surgery Specialist Dr İhsan Bakır from Istanbul University, Istanbul Medical Faculty has made important statements by stating that this warning issued by FDA should be taken seriously for both patients and health professionals.
The Ministry of Health has warned about musculoskeletal risks
Prof Dr Bakır has told the followings about the related issue; “The FDA bases this warning on scientific studies conducted in 2015 and 2018. The latest research took place at JAMA, one of the prestigious medical journals, on September 19, 2018, and the FDA issued a warning after all. Unconscious or uncontrolled use of antibiotics is dangerous enough because it causes unneccessary resistance to the infections in time and increases antibiotic resistance in society. Information about the possible cause of aortic aneurysm and rupture is very new, but should be taken seriously in terms of fatal risks” he said. Professor Dr İhsan Bakır who has pointed out that the Ministry of Health published a warning about antibiotics of fluoroquinolone group in 2017, continued as follows. “The warning issued by the Ministry emphasizes the serious side effects of this group of antibiotics on the musculoskeletal system. It was stated that these risks, which could lead to disability in simple infections, may prevent the benefits of treatment and should not be considered as the first choice treatment. These new studies show that there are risks for the cardiovascular system accordingly” he said.
Changes the DNA of muscle cells
This latest study, published on the subject in JAMA, was carried out by scientists from the Department of Cardiovascular Surgery at the Baylor Faculty of Medicine and the Cardiovascular Research Institute and the Cardiovascular Surgery Department of the Texas Heart Institute and the Stem Cell Research Unit as well. According to the study based on mouse experiments, this active substance antibiotic initiates many adverse reactions, and it may cause damage to the nucleus and mitochondrial DNA of the cell. These reactions also cause rupture of aneurysms in mice with aortic aneurysm. In rats that are prone to aortic aneurysm and have symptoms such as high blood pressure, it causes thinning of the aortic vessel, ballooning, that is, triggering aneurysm formation. Prof Dr İhsan Bakır has made the following warning; “In blood pressure patients, they already have thinning in their vessel wall. In other words, these patients have a high tendency to aortic aneurysm. They are more prone to it. On the other hand, the use of these drugs may trigger tearing, that is, deadly aneurysm bleeding. According to the study, this group of antibiotics doubled the risk unfortunately” he said.
Family physicians and emergency physicians should also be very careful
Dr Bakır who has pointed out that the patients should not use antibiotics without a doctor’s check, continued his words as follows; “Physicians (especially family physicians or emergency physicians) must have made antibiogram test to the patient who had come with the symptoms of infection before they give them an antibiotics, then they should give the antibiotics accordingly. If there is no possibility at that moment or place, the risk factors in the family and the patient should be questioned. This questioning should include all the related issues in terms of both the patient and his family as well, and the questions should be asked about the following issues; high blood pressure, diabetes, sudden death, aortic rupture, ballooning in the aorta (aneurysm), tension-induced stroke, cerebral aneurysm due to tension, fainting, aortic insufficiency, etc. And the questions should include both the patient itself and any one in his family. The primary preference should not to be from fluoroquinolone group. If there is no other option, patients should be followed closely when using these antibiotics” he said.
Rare but deadly!
Aortic aneurysm ruptures are seen in 5 of every 100 thousand people. In fact, this is a rare rate. However, 40 percent of these cases die before reaching the hospital. Prof Dr İhsan Bakır who has said that, 50 percent of patients who would be brought to the hospital are being lost in the first 48 hours, and it is seen two times more in men than women, concluded his speech as follows; “Acute (sudden and unexpected progressing) patient group usually consist of 50-55 age group. The course of heart failure symptoms usually continue with chest pain, severe back pain. Patients often refer to the fact that they have very severe pain just like something is being torn in their bodies” he said.