Fluoroquinolones in orthopaedic infection: balancing risks and rewards.

This article examines recent regulatory restrictions on fluoroquinolone antibiotics and their impact on treating orthopaedic infections, particularly severe cases involving implants. Fluoroquinolones are valued in orthopaedics for their oral bioavailability, bone penetration, and effectiveness against biofilms, making them a preferred treatment for Gram-negative prosthetic joint infections and staphylococcal infections. Despite rare but serious adverse effects linked to fluoroquinolones, such as tendon disorders and aortic aneurysms, current evidence and expert consensus support their use as first-line therapy in severe infections where alternatives may be less effective or carry higher risks. The article highlights the need for balanced risk-benefit assessments, patient-centered decision-making, and improved pharmacovigilance to guide clinical practice and regulatory policies.