Recently on Twitter #ASPchat – A Monthly Conversation On Antimicrobial Stewardship asked medical professionals to weigh-in on “Which fluoroquinolone adverse effects have you seen in practice?” Here are some of their replies:

Tweets are © of their respective authors.  

I realize that this is a very small cross section of medical professionals, however I think we can still formulate a few opinions:

  • More CNS adverse events are being recognized. 
  • The full spectrum of Fluoroquinolone adverse events are still under appreciated by medical professionals.
  • Medical professionals are not trained to recognize the full spectrum of possible adverse events that can occur.
  • Long term adverse events (late effects) are still off the radar to medical professionals.
  • Only a small percentage of medical professionals are recognizing a wider adverse event profile. 
  • Many still think adverse events are rare. 

Whether I agree with their opinion or not, I appreciate their honesty and willingness to share their thoughts, as many medical professionals  would say “I’ve never seen any of those side effects,” as suggested by one doctor above. 

As I have written about before, I believe that many, many doctors engage in cognitive dissonance. 

Cognitive dissonance is a universal human phenomenon and it is based on the assumption that people want consistency between their expectations and reality. Because of this, they contort their thinking into knots to make that happen. In the case of FQ adverse events, it is to preserve the notion that our efforts help rather than hurt so their impulse is to attribute the harm to something other than their intervention.

Combine cognitive dissonance, along with paradigms taught in medical school, drives the failure to connect adverse events to the guilty the FQ’s. This not only fails the patients, but again it fails in reporting statistics which leads the FDA to grossly underestimate the ADE’s experienced by patients. The bottom line is that doctors and patients believe that the FQ’s are much safer than they really are…and they cling to this belief, despite evidence to the contrary.

Again, I appreciate these medical professionals sharing their opinions and ask that my readers respect that right.