Fluoroquinolones: clearer evidence and guidance on safety are needed

Doctors learn early in their careers about the central importance of communication in medicine. Discussion of the relative risks and benefits of various treatment options, while considering the wider evidence and an individual patient’s circumstances and views, is challenging. The same challenge applies to guidance delivered from central bodies: it must be sensibly communicated, clear, based on published evidence, and applicable to a wide range of individual situations.However, when the UK’s Medicines and Healthcare Products Regulatory Agency (MHRA) posted a drug safety update on fluoroquinolones in January 2024, stating that with immediate effect systemic fluoroquinolones “must only be administered when no other antibiotics are appropriate for use,”1 many clinicians were blindsided. Some heard it on the national news before the official email notification arrived. There was no opportunity to prepare alternative prescribing guidelines or to offer any reassurance to patients, as the MHRA hadn’t shared the new evidence on fluoroquinolones…
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