In a new study, researchers found users of fluoroquinolone antibiotics, such as Ciprofloxacin or Cipro, face a 2.4 times greater risk of aortic and mitral regurgitation compared to patients who take amoxicillin, a different type of antibiotic.
Aortic and mitral regurgitation are heart conditions in which the blood back-flows into the heart. The greatest risk is within 30 days of use.
This study is the first showing a link between two types of heart problems and one of the most commonly prescribed classes of antibiotics.
The research was done by a team from the University of British Columbia and other institutes.
Some physicians favor fluoroquinolones over other antibiotics for their broad spectrum of antibacterial activity and high oral absorption, which is as effective as intravenous, or IV, treatment.
Recent studies have also linked the same class of antibiotics to other heart problems.
In the study, the team analyzed data from the U.S. FDA’s adverse reporting system.
They also analyzed a massive private insurance health claims database in the U.S.
They found 12,505 cases of valvular regurgitation with 125,020 case-control subjects in a random sample of more than nine million patients.
They defined current fluoroquinolone exposure as an active prescription or 30 days prior to the adverse event, recent exposure as within days 31 to 60, and past exposure as within 61 to 365 days prior to an incident.
The team compared fluoroquinolone use with amoxicillin and azithromycin.
The results showed that the risk of aortic and mitral regurgitation, blood back-flow into the heart, is highest with current use, followed by recent use.
They saw no increased risk of aortic and mitral regurgitation with past use.
The team says doctors can send patients home with a once-a-day pill. This class of antibiotics is very convenient, but for the majority of cases, especially community-related infections, they’re not really needed.
The inappropriate prescribing may cause both antibiotic resistance as well as serious heart problems.
The researchers hope their study helps inform the public and physicians that if patients present with cardiac issues, where no other cause has been discovered, fluoroquinolone antibiotics could potentially be a cause.
The lead author of the study is Mahyar Etminan, an associate professor of ophthalmology and visual sciences at UBC.
The study is published in the Journal of the American College of Cardiology.
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