It is safe to say that predisposition or susceptibility to an adverse event (AE) from a fluoroquinolone (FQ) is still largely an unknown multifaceted set of variables. That is why it is incumbent upon us to warn our friends and loved ones about the dangers of FQ AE’s, because as we know, there is no going back once you cross that Rubicon. Researchers have known for many years that AE’s pertaining to toxicity from pharmaceuticals can can appear weeks, months or even years after exposure (1).
Before we go any further please note that nothing contained herein is to be construed as medical advice for, I must confess that I am not a doctor, nor do I have any formal medical background. If you continue, it is assumed you agree to my disclaimer.
Generally, I do not recommend FQ use in any population and, at the minimum, I would like to see FQ use restricted to institutional life or death situations with informed consent. Having said that, over the years some correlations have emerged in my interactions that lead me to believe that some populations are at greater risk for more severe FQ AE’s than others.
I will throw in the caveat that just because a group is not listed here doesn’t mean that a person is not highly susceptible to having a FQ AE. Predisposition to toxicity is often either pharmacodynamic which means something is causing increased tissue sensitivity, or it can be pharmacokinetic which means increased concentrations of the drug (large doses) or metabolites (broken down subunits of the drug) become toxic due to abnormal absorption, distribution, or problems with elimination (1).
Personally, I believe, given the right amount of an FQ for a long enough period of time, anyone, and I mean anyone, would eventually have an AE.
Again, I believe everyone should use caution and discuss the risk and dangers with your doctor if you have any questions. This information is just loose correlations that I have extrapolated from my data over the years, which is hardly all encompassing (I will add more possible predispositions as correlations become apparent).
I believe the following groups should exercise extreme caution:
Again, some of these correlations are weaker than others, but they have shown up in anecdotal data. The reference links that are provided are for information only and provide information to the possibility as why a susceptible predisposition could occur.