Fluoroquinolones for pneumonia

Examples

Fluoroquinolones are also known as quinolones.

How It Works

Fluoroquinolones make it difficult for bacteria to reproduce.

Why It Is Used

Doctors may use fluoroquinolones to treat pneumonia and other lung diseases, such as acute bronchitis, in people older than 18.

How Well It Works

In general, all antibiotics used have a high cure rate for pneumonia. For people in the hospital, cure rates are 73% to 96%; outside of the hospital, cure rates are generally above 80%.¹

Fluoroquinolones generally are very effective.

• One fluoroquinolone medicine may be effective against many types of bacteria.²
• How effective a fluoroquinolone is against resistant bacteria varies. For example, ciprofloxacin may not work well against some types of Streptococcus pneumoniae, and levofloxacin may work better.³
• Fluoroquinolones are useful against some bacteria that are resistant to penicillin and erythromycin.

Side Effects

Side effects from fluoroquinolones may include:

• Nausea and vomiting.
• A metallic taste in the mouth.
• Headache.
• Dizziness.
• Increased sensitivity to the sun (phototoxic reaction).
• Rash.

These antibiotics increase the risk of a tendon rupture or other tendon damage. If you have sudden pain or swelling around your ankle, shoulder, elbow, or hand while taking one of these medicines, tell your doctor. Do not exercise until your doctor says it is okay.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Some fluoroquinolones may make it easier to get a sunburn when you are taking one of them. Avoid direct sunlight and tanning salons while you are taking these fluoroquinolones and for 5 days after you have stopped taking them.

• Most sunscreens do not block enough of the ultraviolet rays to avoid a reaction to the sun (phototoxic reaction).
• If you cannot avoid direct sunlight, cover as much of your body as you can with clothing.

Fluoroquinolones have been approved for use in people older than 18. The effectiveness and safety of these medicines have not been established for the following people:

• People younger than 18. Children younger than age 8 should not take quinolones unless they are prescribed by a specialist, because the medicine may damage the tissue on the ends of the bones (cartilage ) and may cause a torn tendon (rupture).
• Pregnant women
• Women who are breast-feeding

If you have kidney problems, your doctor may prescribe a lower dose of these medicines to reduce the possibility of side effects.

If you are taking the blood-thinning medicine warfarin (Coumadin), your doctor may need to reduce your dose after you start fluoroquinolone treatment.

You typically take levofloxacin and moxifloxacin once a day. This may make it easier for you to remember to take the medicine.

Although the newer fluoroquinolones, such as levofloxacin and moxifloxacin, are highly effective at killing most of the bacteria that can cause pneumonia, they are not always used first. This is because of the concern that overusing fluoroquinolones may result in them becoming less effective against bacteria (resistant).

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

Citations

1. Loeb M (2006). Community acquired pneumonia, search date April 2005. Online version of Clinical Evidence (15): 1-10.

2. Niederman MS (2004). Pneumonia, including community-acquired and nosocomial pneumonia. In JD Crapo et al., eds., Baum's Textbook of Pulmonary Diseases, 7th ed., vol. 1, pp. 424-454. Philadelphia: Lippincott Williams and Wilkins.

3. Hueston WJ (2003). Pneumonia. In WJ Hueston, BD Weiss, eds., 20 Common Problems in Respiratory Disorders, pp.171-189. New York: McGraw-Hill.

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