[Comparison of the adverse effect profile of different substances such as penicillins, tetracyclines, sulfonamides and quinolones].

The penicillins, the tetracyclines and the sulfonamides have often been used in the last few decades in spite of their well-known side effects. Hypersensitivity reactions to penicillins are among the most important adverse reactions in these antibiotics; in every case a careful medical history has to be taken before a new course of penicillin treatment. The use of tetracyclines in women during the last six months of pregnancy or in children under the age of eight years is contraindicated. Patients with severe blood, kidney or liver disease should not be treated with sulfonamides. Toxic reactions to penicillin even with convulsions may occur in patients with renal insufficiency if the dosage is not adapted. The fluoroquinolones do not seem to have greater risks regarding adverse reactions than the historical compounds mentioned. Neurotoxicity is an important problem. Mild reactions are reported with incidences under 2%; severe neurotoxic side effects that require interruption of therapy are rare. Psychotic reactions, hallucinations, depressions and grand mal convulsions also belong to this category. Other side effects (skin, GI-tract) are no more frequent than with the classical antibiotics. In patients with renal insufficiency the dosage of ofloxacin has to be adapted. The cartilage lesions which are seen in juvenile rats and dogs raise the question whether or not the cases of arthralgia during therapy with older quinolones as well as under treatment with fluoroquinolones have a causal relationship. Up to date quinolones should not be prescribed in children and young adults except in cases with cystic fibrosis. The development of resistance has not been a significant problem so far.(ABSTRACT TRUNCATED AT 250 WORDS)