A joint meeting of the FDA’s Antimicrobial Drugs Advisory Committee and the Drug Safety and Risk Management Advisory Committee was held to discuss the use of fluoroquinolones for certain indications, namely acute bacterial sinusitis, acute bacterial exacerbation of chronic bronchitis in COPD patients, and uncomplicated urinary tract infection.

The group voted overwhelmingly that the benefits did not outweigh the risks for the aforementioned indications, which are currently licensed indications. In some instances practice guidelines do not advocate their use, particularly for mild infections.

They also called for stronger warnings for some of the more serious adverse events such as tendonitis, tendon rupture, QT interval prolongation and peripheral neuropathy; possibly even a black box warning.

This further underscores the importance of antibiotic stewardship as well. We need to ask ourselves: Is an antibiotic actually indicated and if so, what are the best choices based on current evidence?