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Study Sees Higher Liver Risks with Levaquin, Avelox Antibiotics

Aug 14, 2012 | Parker Waichman LLP

Levaquin (levofloxacin) and Avelox (moxifloxacin), antibiotics known as fluoroquinolones, have been linked to an increased risk of severe liver injuries in elderly people.  According to a new study published August 13 in the Canadian Medical Association Journal, of the two drugs, Avelox has the highest liver injury risk, but it and Levaquin are both associated with a statistically significant risk of hepatotoxicity.

Levaquin, Avelox and other fluoroquinolones are used to treat bacterial infections including respiratory infections and sinus infections.  In recent years, health regulators in Europe and Canada have issued liver injury warnings for Avelox.  However, few studies have been conducted to the safety of fluoroquinolones, especially related to liver damage.

For this new study, Canadian researches examined the risk of acute liver injury in patients taking Avelox compared with those taking other commonly used antibiotics.   They analyzed the medical records of 144 patients in Ontario who were over 65 and admitted to the hospital to treat liver injury within a month of receiving one of the antibiotics.  None of the subjects had a previous history of liver disease.  Of the 144 patients studied, 88 patients died during their stay in hospital.

Overall, Avelox was associated with a more than 2-fold increased risk of admission to hospital for acute liver injury compared to clarithromycin.  Avelox had a higher risk than Levaquin, but Levaquin's association with liver injury was still statistically significant, the study authors said.

The study authors called for further studies of Levaquin and Avelox, as well as additional safety warnings regarding their association with acute liver injury.

"Despite recent regulatory warnings regarding the hepatic safety of moxifloxacin, there is a lack of controlled studies supporting the notion that moxifloxacin presents a particular risk relative to other broad-spectrum antibiotic agents and, in particular, to other fluoroquinolones," write the authors.

"Although our results require confirmation in other settings, the findings suggest that both moxifloxacin and levofloxacin be considered for regulatory warnings regarding acute liver injury,” they conclude.

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