If you take a certain class of antibiotics, you may be doubling your risk of acute kidney disease, according to a study published June 3, 2013 in the Canadian Medical Association Journal (CMAJ).

Fluoroquinolone antibiotics, which include ciprofloxacin (Cipro), levofloxacin and moxifloxacin, are common broad-spectrum antibiotics that are used frequently to treat respiratory and urogenital infections.

However, there have been case reports indicating that using such antibiotics may cause acute kidney disease – despite prescription labels warning of possible kidney failure.

Accordingly, a research team from the U.S. and Canada launched a study to determine the risk of acute kidney injury with the use of oral fluoroquinolones. Participants in the study were adult men 40 to 85 years old, who were enrolled in the U.S. LifeLink Health Plan Claims Database between 2001 and 2011.

Of those participants, there were 1292 cases of acute kidney disease. Researchers excluded people with a history of chronic kidney disease or dialysis, as they can raise the risk of acute injury.


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For the participants in the study, the researchers found that current use of oral fluoroquinolones increased the risk of acute kidney injury, with the greatest risk being those on ciprofloxacin, with moxifloxacin coming in second.

Previous use of these antibiotics did not increase the risk of acute kidney disease, and the same goes for prior use of amoxicillin or azithromycin. Moreover, the researchers found that concurrent use of an oral fluoroquinolone with a renin-angiotensin-system blocker (a popular class of cardiovascular medication), more than quadrupled the risk of acute renal failure.

"We found a twofold increased risk of acute kidney injury requiring hospital admission with the use of fluoroquinolone antibiotics among adult men, using 2 analytic techniques," said Dr. Mahyar Etminan, of the Child & Family Research Institute, Department of Pediatrics, University of British Columbia, and the Provincial Health Services Authority.

"The twofold differential in risk between current and both recent and past fluoroquinolone use suggests that acute kidney injury is an acute adverse effect of fluoroquinolones," Etminan and co-authors added.

According to the authors, physicians need to know the risks of kidney injury when prescribing these antibiotic drugs.

"Although it is clear that the risk of death due to serious infections outweighs the risks associated with the use of fluoroquinolones, the potential for acute kidney injury raises the importance of vigilant prescribing," the research team concluded.

SOURCE: “Risk of acute kidney injury associated with the use of fluoroquinolones”, Steven T. Bird. CMAJ, First published June 3, 2013; DOI:10.1503 /cmaj.121730