Fluoroquinolones

In January 2024, the MHRA published a Drug Safety Update on fluoroquinolone antibiotics. These must now only be prescribed when other commonly recommended antibiotics are inappropriate. NICE is assessing the impact of this warning on recommendations in this guideline.

Click this link to access the MHRA website hosting the latest (January 2024) version of the fluoroquinolone patient information sheet. See hyperlink in bullet six of the “Advice for healthcare professionals” box: “refer to MHRA’s sheet for patients (regular print or large print) for further advice”.

The Patient Information Leaflet (PIL) advises patients that they may experience psychiatric reactions. If patients suffer from depression or psychosis before being prescribed this medication, their symptoms may become worse under treatment.

It is not possible from available data to indicate a frequency nor period of risk for these potential adverse reactions. Patients should be advised to seek medical attention for any psychiatric symptoms, even if it has been some time since they stopped taking the medication.

Find out more on GOV.UK.

  • Avoid fluoroquinolone use in patients who have previously had serious adverse reactions with a quinolone antibiotic (for example, nalidixic acid) or a fluoroquinolone antibiotic
  • Prescribe fluoroquinolones with special caution for people older than 60 years and for those with renal impairment or solid-organ transplants, because they are at a higher risk of tendon injury
  • Avoid coadministration of a corticosteroid with a fluoroquinolone since this could exacerbate fluoroquinolone-induced tendinitis and tendon rupture.

Find out more on GOV.UK.