In Practice

Rational use of the fluoroquinolones

G A Richards, A J Brink, C Feldman


The systemic fluoroquinolones (FQs) have recently been reported to be associated with significant side-effects in susceptible individuals. This has prompted the Food and Drug Administration (FDA) in the USA and the European Medicines Agency (EMA) to issue warnings regarding their use. The FQs should not be used for common bacterial infections, such as urinary tract infections, travellers’ diarrhoea and upper and lower respiratory tract infections, unless it is not possible to use another oral agent. There are situations, however, in which these agents are not only effective, but their benefit outweighs the risk. These include the management of conditions such as acute prostatitis, typhoid fever, prosthetic joint infections, multidrug-resistant tuberculosis, certain hospital-acquired infections and situations where the organism is susceptible to FQs, which could then be administered orally. Alternatively, the patient would have to be admitted to hospital for parenteral therapy.

Authors' affiliations

G A Richards, Department of Critical Care, Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

A J Brink, Department of Medical Microbiology, Faculty of Health Sciences, University of Cape Town, South Africa

C Feldman, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

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Fluoroquinolones; Adverse events; Uses

Cite this article

South African Medical Journal 2019;109(6):378-381. DOI:10.7196/SAMJ.2019.v109i6.14002

Article History

Date submitted: 2019-05-31
Date published: 2019-05-31

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