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The GP news area gives primary care providers up to date information, news and developments about Moorfields Eye Hospital NHS Foundation Trust.

MHRA guidance on fluoroquinolones 16 April 2024

The Medicines and Healthcare products Regulatory Agency (MHRA) has published information stating that systemic fluoroquinolones must now only be prescribed when other commonly recommended antibiotics are inappropriate. This follows a review by the MHRA which looked at the effectiveness of current measures to reduce the identified risk of disabling and potentially long-lasting or irreversible side effects.
 
For more information, please see the following link: https://www.gov.uk/drug-safety-update/fluoroquinolone-antibiotics-must-now-only-be-prescribed-when-other-commonly-recommended-antibiotics-are-inappropriate
 
There are many fluoroquinolones available but the most commonly prescribed at Moorfields Eye Hospital include Ciprofloxacin and Moxifloxacin.
 
At Moorfields, fluoroquinolones will be prescribed in line with the Trust’s antimicrobial guideline to treat sight threatening infections only.  
Serious side effects that have been reported are those involving tendons, muscles, joints, nerves, or mental health – in some patients, these side effects have caused long-lasting or permanent disability.
 
Healthcare professionals must consider and provide patients with the below information when fluoroquinolones are prescribed and supplied.

 
Stop taking your flouroquinolone antibiotic and contact your doctor immediately if you have the following signs of side effect:

• Tendon pain or swelling, often beginning in the ankle or calf – if this happens, rest the painful area until you can see your doctor
• Pain in your joints or swelling in your shoulder, arms, or legs
• Abdominal pain or sensations (such as persistent pins and needles, tingling, pricking, numbness, or burning), weakness in your body, especially in the legs or arms, or difficulty walking
• Severe tiredness, depressed mood, anxiety, panic attacks, confusion, problems with your memory, or severe problems sleeping
• Changes in your vision, taste, smell, or hearing

Situations in which other antibiotics are considered to be inappropriate and where a fluoroquinolone may be indicated are where:

• There is resistance to other first-line antibiotics recommended for the infection
• Other first-line antibiotics are contraindicated in an individual patient.
• Other first-line antibiotics have caused side effects in the patient requiring treatment to be stopped.
• Treatment with other first-line antibiotics has failed.

• Ophthalmic Formulary V1.46 February 2025
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