Fluoroquinolones, patients denounce a “health scandal”

Is a “health scandal” hiding behind fluoroquinolones, antibiotics used against serious bacterial infections? In any case, this is what dozens of patients who have suffered adverse effects claim. According to France Info, a first complaint was filed on Monday March 13 and others should follow during the week. The plaintiffs denounce “six million poisonings in France in four years” as well as the negligence of the health authorities, reports the media.

Marketed under different names – Oflocet, Ciflox or even Tavanic – fluoroquinolones “have been used extensively for around forty years to treat urinary tract infections, bronchitis, ear infections…, lists Professor Mathieu Molimard, head of the pharmacology department doctor of the Bordeaux University Hospital and member of the French Society of Pharmacology and Therapeutics (SFPT). These are very effective drugs, but over time, significant risks have emerged, especially in the elderly. »

Serious and potentially irreversible side effects

Tendinitis, aneurysm or aortic dissection, damage to the heart valves or even neuropsychiatric disorders… The seriousness and, in some cases, the irreversibility of the adverse effects, led the European Medicines Agency (EMA) to reassess the benefit/risk ratio of these antibiotics in 2018-2019.

In France, the National Medicines Safety Agency (ANSM) also revised its recommendations at the same time. Fluoroquinolones “should only be prescribed after carefully weighing their benefits against the risks of expected adverse effects, and after informing the patient,” reads its website.

While consumption has fallen in recent years, the number of undue prescriptions remains high. According to a study by the EMA, more than two thirds of prescriptions for fluoroquinolones in France are made outside the framework defined by the authorities.

Mathieu Molimard invokes the weight of habit. “Doctors have been prescribing them for thirty years, for some it’s almost a reflex”, underlines the pharmacologist, while insisting on the usefulness of these antibiotics in certain cases. “They are sometimes essential, but when this is not the case, it is better to favor therapeutic alternatives, in particular for benign pathologies. »

” Brake on “

For Fabien Dutet, pharmacist in Mayenne, the awareness of health professionals is already old. “With us, we deliver these molecules daily, but the doctors have a much lighter hand than a few years ago, he says. Most often, they are not given in first intention but in second, when the patients are confronted with recurrent infections. »

According to him, most doctors are careful to warn their patients about the specifics of the treatment. “They know that they should not expose themselves to the sun, or do violent sports in the days following the treatment”, reports the pharmacist.

Insufficient in the eyes of Mathieu Molimard, for whom the authorities must quickly put a “brake” on the abusive prescription of fluoroquinolones. “We cannot wait ten years of trial to change practices. Constraints must be put in place, as for Depakine (an antileptic that can cause malformations in the fetus, editor’s note). If a doctor wants to prescribe it, he must have a care agreement form signed. This paper alone could significantly reduce the number of fluoroquinolone prescriptions. They should no longer be automatic. »

A goal before which stands a major obstacle, according to Fabien Dutet: the shortage of amoxicillin, the most commonly prescribed antibiotic in France. “We can imagine that the difficulty of obtaining them leads to postponements on fluoroquinolones, in particular for patients with respiratory infections, underlines the pharmacist. As long as there is a shortage of amoxicillin, the consumption of these first-line antibiotics is unlikely to drop. »

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