UNCONSCIOUS USE OF ANTIBIOTICS MAY EVEN LEAD TO AORTIC RUPTURES

According to a recent research published by the US Food and Drug Administration (FDA), fluoroquinolone-group antibiotics, of which adverse effects are already controversial, may cause aortic ruptures.
According to a recent research published by the US Food and Drug Administration (FDA), fluoroquinolone-group antibiotics, of which adverse effects are already controversial, may cause aortic ruptures. Another recent research shows that these antibiotics should be used very carefully in patients at risk even under physician supervision.
From İstanbul University Faculty of Medicine, Cardiovascular Surgeon Prof. İhsan Bakır, M.D. says that aortic aneurysm that has a sneaky course without any symptom and manifests itself directly with vascular rupture has a high death risk. Prof. İhsan Bakır, M.D. states that individuals with history of hypertension, high cholesterol in the family history or in their own history, sudden death case in family, blood pressure related stroke or brain aneurysm, diabetes, fainting, aortic failure or similar problems are at risk for aortic aneurysm and continued:

“The US Food and Drug Administration (FDA) published a serious warning about the subject for patients and healthcare professionals in December 20. Accordingly, the use of “fluoroquinolone” which is commonly used in the treatment of urinary tract infections and lower respiratory tract infections such as bronchitis, pneumonia should be restricted in patients at risk and other drugs should be preferred if possible. Because such drugs cause a change in the DNA of smooth muscle cells and damage these cells. This can therefore cause thinning, aneurysm or even ruptures in aortas, leading to fatal hemorrhage. This warning published by FDA must be taken very seriously both for patients and healthcare professionals.”

‘MINISTRY OF HEALTH WARNED ABOUT MUSCULOSKELETAL SYSTEM RISKS
Prof. İhsan Bakır, M.D. says, “FDA grounds this warning on the scientific studies performed in 2015 and 2018. The most recent research was published in JAMA, a prestigious medical journal, in September 19, and FDA published the warning based on that. Unconscious or uncontrolled use of antibiotics is already a dangerous situation as it causes resistant infections and increased antibiotic resistance in society. While information on that it can cause aortic aneurysm and ruptures, it must be taken seriously for its fatal risks.”

Prof. İhsan Bakır, M.D. calls attention to the warning published by Ministry of Health on fluoroquinolone-group antibiotics in 2017 and adds, “The warning addressed severe adverse effects of such antibiotics on musculoskeletal system and emphasized that this risks which may even end up with disability in case of using the drugs in simple infections can prevent benefits of treatment and stated that they should not be the first-choice treatment. These recent studies show that they also have risks for cardiovascular system.”

‘IT CHANGES THE DNA OF MUSCLE CELLS’
The most recent research published on the subject in JAMA is a study carried out by scientists from the Cardiopulmonary Surgery Department of Baylor College of Medicine, the Cardiovascular Surgery Department of Texas Heart Institute and the Stem Cell Research Unit. According to the study conducted with mouse experiments, antibiotics involving this drug substance cause damage on the nucleus and mitochondrial DNA of the cell, inducing several negative reactions. These reactions, in turn, lead to aneurysm rupture in the mice with aortic aneurysm and cause thinning and aneurysm in the aorta of mice with hypertension, etc. and inclination to aortic aneurysm. Prof. İhsan Bakır, M.D. warns, “Hypertensive patients already have a thin vicinity around the aorta. In other words, such patients are highly likely to have aortic aneurysm. And using these drugs can trigger ruptures, that is, fatal aneurysm hemorrhage. According to the research, these antibiotics double the risk.”

‘FAMILY PHYSICIANS AND EMERGENCY PHYSICIANS SHOULD BE VERY CAREFUL AS WELL’
Addressing that patients should not use antibiotics without physician supervision anyway, Prof. İhsan Bakır, M.D. continues as follow:
“Physicians should perform an antibiogram test on the patient with infection before starting antibiotics and prescribe antibiotics accordingly.” If it is not possible, risk factors in the family and patient himself/herself should be investigated. Even if any of the histories (own or family) of hypertension, diabetes, sudden death, aortic rupture, ballooning in aorta (aneurysm), blood pressure-related stroke, blood pressure-related brain aneurysm, syncope, aortic failure, the first choice should not be the fluoroquinolone-group antibiotics. If there is no other option, patients should be closely monitored as they use these antibiotics.”

‘RARE BUT FATAL’
Prof. İhsan Bakır, M.D. states that although aortic aneurysm is observed in 5 in every 100 thousand people, that is, rarely, 40 percent of these cases end up with death before arrival at hospital, adding “50 percent of patients that could be taken to hospital are lost in the first 48 hours. It is two times more prevalent in males than in females. Acute patient group is usually composed of 50-55-years-old individuals. Heart failure findings are accompanied by chest pain and severe back pain. Patients generally consult with the complaint ‘I have a very strong, tear-like pain’.” – İstanbul