Warning over two types of antibiotic
TWO antibiotics, one used in the treatment of kidney infections and the other used for bronchitis, pneumonia and sinus infections, are to be restricted under an instruction from the Irish Medicines Board.
The first, norfloxacin, used to treat complicated acute and chronic kidney infections is to be withdrawn for this type of patient because the risks outweigh the benefits.
The second, moxifloxacin, linked to deaths from liver failure, is only to be prescribed where other antibiotics cannot be used or have failed. The board is also recommending a strengthening of the warnings for these medicines.
Norfloxacin has been linked to serious nerve problems, tendon damage and a severe infection of the colon in some patients.
It is used in all EU member states to treat simple or complicated urinary tractions, infection of the prostate, uncomplicated gonorrhoea, several types of gastroenteritis and conjunctivitis.
The second drug, used to treat chronic bronchitis, pneumonia and sinus problems, has been linked to heart failure in woman and older patients, severe skin reaction and fatal liver injury.
The IMB is instructing doctors to only use this medicine "when other antibiotics cannot be used or have failed".
In both cases the IMB decision follows recommendations by the European Medicines Agency which says that in the use of either medicine the risks outweigh the benefits.
A review by the Agency found that norfloxacin can "no longer be supported" in the treatment of acute or chronic kidney infection. The recommendation does not apply to the use of this medicine for other types of infection.
Around 180,000 people in Ireland currently have chronic kidney disease and the numbers are growing at the rate of about 20pc a year.
Doctors are being advised not to prescribe oral forms of norfloxacin medicines for complicated kidney infections and to consider switching patients to an alternative antibiotic.
In the case of the second antibiotic a review found eight cases of liver problems which led to the patients' death were "suspected to be related to moxifloxacin".
The review concluded that the medicine should only be used when treatment with other antibiotics "cannot be used or have stopped working".
In the case of the first antibiotic, norfloxacin, it has been linked to "serious nerve problems that may be reversible if identified and treated early".