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Peripheral neuropathy and development of Guillain-Barré syndrome during treatment with fluoroquinolones

Peripheral neuropathy is a possible complication of systemic antibiotic therapy with the appointment of fluoroquinolones. At the same time, the risk factors for the development of this undesirable drug reaction and its severity, in particular the occurrence of Guillain-Barré syndrome, have not been precisely determined in the various drugs in this group.

A study by an Eli Lilly employee examined the relationship between the use of fluoroquinolones and the development of peripheral neuropathy and Guillain-Barré syndrome based on an analysis of the spontaneous message cases available in the Adverse event reporting system (FDA) of the United States Food and Drug Administration. Event Reporting System) for the period from 1997 to 2012. The individual fluoroquinolone preparations were analyzed by DCI and route of administration. The Bayes empirical geometric mean (EBGM) with a 95% confidence interval (EB05-EB95) was used as a measure of disproportionality.

A total of 539 cases of peripheral neuropathy were identified out of 46,257 reports of NLR resulting from fluoroquinolone therapy. Of all peripheral neuropathies, 9% were represented by Guillain-Barré syndrome. A statistically significant disproportion during treatment with fluoroquinolones was determined for peripheral neuropathy (EBGM 2.70; EB05-EB95 2.51-2.90) and Guillain-Barré syndrome (EBGM 3.22; EB05- EB95 2.55-4.02) Signs of development of peripheral neuropathy have been established for ciprofloxacin (EBGM 3.24; EB05-EB95 2.87-3.66) and levofloxacin (EBGM 3.36; EB05-EB95 3.02-3.72). Signs of development of Guillain-Barré syndrome have been established for ciprofloxacin (EBGM 4.15; EB05-EB95 2.94-5.74). Guillain-Barré syndrome and peripheral neuropathy, respectively, occupied 6th and 8th place among all the neurological adverse events reported.

Thus, in this study, the relationship between the use of fluoroquinolones and the development of peripheral neuropathy was established, and the possibility of more severe forms of peripheral neuropathy, such as Guillain-Barré syndrome, was also established. demonstrated. In this regard, unless the benefit of the use of fluoroquinolones outweighs the possible risk of developing peripheral neuropathy (for example, severe infection or disease caused by pathogens resistant to other SPAs), physicians should consider the use of other alternative antibiotics.

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