The study published in the Journal of the American College of Cardiology found that patients taking fluoroquinolone antibiotics, such as Ciprofloxacin or Cipro, face a 2.4 times greater risk of developing aortic and mitral regurgitation compared to patients who take amoxicillin, a different type of antibiotic. Aortic regurgitation and mitral regurgitation are conditions where the blood backflows into the heart.
Mahyar Etminan, lead author and associate professor of ophthalmology and visual sciences in the faculty of medicine at UBC, said, “You 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.”
Broad Spectrum of Antibacterial Activity
Many doctors tend to prescribe fluoroquinolones over other antibiotics because of their broad spectrum of antibacterial activity. They also have high oral absorption, which is as effective as intravenous, or IV, treatment.
“One of the key objectives of the Therapeutic Evaluation Unit is to evaluate different drugs and health technologies to determine whether they enhance the quality of care delivered by our programs or improve patient outcomes,” said Dr. Bruce Carleton, director of the unit and research investigator at BC Children’s Hospital, a program of PHSA. “This study highlights the need to be thoughtful when prescribing antibiotics, which can sometimes cause harm. As a result of this work, we will continue working with the BC Antimicrobial Stewardship Committee to ensure the appropriate prescribing of this class of antibiotics to patients across British Columbia and reduce inappropriate prescribing.”
The study had researchers analyzing data from the U.S. Food and Drug Administration’s adverse reporting system. They also looked at a database that holds massive private insurance health claims in the U.S. that captures demographics, drug identification, dose prescribed, and treatment duration.
They found 12,505 cases of valvular regurgitation with 125,020 case-control subjects in a random sample of more than nine million patients. The findings were divided into three different groups including 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 conclusion of the study showed that the risk of aortic and mitral regurgitation, blood backflow into the heart, is highest with current use, followed by recent use. There was no evidence of increased risk aortic and mitral regurgitation with past use.
Recent studies have also linked this same class of antibiotics to other heart problems, so researchers hope this study will help to inform the public and physicians of additional health risks. Fluoroquinolone antibiotics could potentially be a danger for patients with cardiac issues, where no other cause has been discovered.