A new report says that drugs in the same class as Avelox were the class most often associated with reports of persistent adverse effects in 2015.

The report was published in QuarterWatch, a regular publication of the Institute for Safe Medication Practices that reviews reports made to the FDA about drug-related adverse events.

In its annual report issue covering reports from 2015, the ISMP found that fluoroquinolone antibiotics like Avelox were the single class of drugs most often associated with persistent adverse effects that became long-term health issues.

Most of the persistent problems related to Avelox injuries and those of other fluoroquinolones reported were joint, muscle or tendon disorders, with associated pain and discomfort. In 65 percent of the reported cases, the effects were reported to be disabling.

Fluoroquinolones and their Side Effects

As a class, the six fluoroquinolones approved for U.S. sale by the FDA are the most widely prescribed antibiotic in the U.S. The ISMP report notes that in the fourth quarter of 2015 alone, fluoroquinolones ciprofloxacin and levofloxacin accounted for over 9 million prescriptions written in the fourth quarter of 2015 alone.

Annually, fluoroquinolones usually account for 26 million prescriptions in the U.S.

Avelox, or moxifloxacin, is the third most frequently prescribed fluoroquinolone in the U.S. It was originally approved by the FDA in 1999.

Even though they are in such widespread use, fluoroquinolones have been associated with certain side effects, some of which may persist after the patient stops using the drug. Avelox injuries may include aortic injuries like aneurysm or dissection, peripheral neuropathy, or tendon ruptures that can leave patients permanently disabled.

The FDA’s Warning on Avelox Injuries

An FDA warning issued in May 2016 addressed the problem of these Avelox injuries and complications of other fluoroquinolones for patients with certain conditions.

The FDA now advises doctors and patients that “the serious side effects associated with fluoroquinolone antibacterial drugs generally outweigh the benefits for patients with acute sinusitis, acute bronchitis, and uncomplicated urinary tract infections who have other treatment options.”

The agency now recommends that patients with these conditions be prescribed fluoroquinolones only if they have no alternative treatments.

With that communication, the FDA also mandated that new safety information be added to the labeling for all quinolones. The agency says it will continue to investigate the issue and will update the public with essential information as it becomes available.

Avelox Injuries and Stevens Johnson Syndrome

One of the rarer but more severe potential Avelox injuries is Stevens Johnson Syndrome, a reaction associated with fluoroquinolone antibiotics in particular in addition to many other kinds of medications.

Patients with Stevens Johnson Syndrome suffer from a rash that spreads across the body and forms blisters within the affected areas. The blisters enlarge and peel away from the lower layer of skin, sometimes exposing large portions of the body surface area to infection.

The condition causes similar lesions on the mucous membranes, particularly those lining the inside of the eyelid. Patients may suffer from inflammation of the conjunctiva, severe purulence, and corneal scarring that can put them at risk for permanent blindness.