Fluoroquinolone Antibiotics Warning For Neuropathy Patients

Today's post from zedie.wordpress.com (see link below) is a very short one but is none the less important for that. Depending on the infection in your body from whatever cause, you may be prescribed antibiotics. Some of these antibiotics are called fluoroquinolones and are notorious for causing neuropathic symptoms. Very often it will be difficult to spot the name fluoroquinolone on the box because the brand and pharmaceutical names will be most prominent. If you already have neuropathy, it may be worth asking your doctor if the antibiotics he/she is prescribing belong to the fluoroquinolone family. If so, it may be worth changing them - there are plenty of alternatives. This short post talks about the American FDA requiring that drug companies place a neuropathy warning on fluoroquinolone packaging. This is of benefit to neuropathy sufferers but also patients who may be at risk of getting neuropathy.

Fluoroquinolone Labels Updated to Reflect Heightened Risk for Peripheral Neuropathy.
Author Zedie: US Virgin Islands August 16th 2013


The FDA is requiring that the labels of fluoroquinolone antibiotics warn of the drugs’ increased risk for peripheral neuropathy.

The risk has been observed with oral and injectable fluoroquinolones, but not topical agents. Patients could experience peripheral neuropathy any time during their treatment, and it could persist for months or years or be permanent.

Patients should contact their healthcare providers if they develop symptoms consistent with peripheral neuropathy in the arms and legs, including pain, burning, numbness, or weakness; change in sensation to touch, pain, or temperature; or change in the sense of body position.

Patients who develop these symptoms should stop taking the antibiotic and receive alternative therapies unless the benefit of the fluoroquinolone outweighs the risk.

Source: FDA MedWatch safety alert

http://zedie.wordpress.com/2013/08/16/fluoroquinolone-labels-updated-to-reflect-heightened-risk-for-peripheral-neuropathy/

Fluoroquinolone Antibiotics And Neuropathy A Report

Today's important post from the Journal of Investigative Medicine at hic.sagepub.com (see link below) is another piece of the jigsaw showing how dangerous fluoroquinolone antibiotics can be for people whether living with, or prone to, nerve damage (neuropathy). It's quite long but worth reading because it's very important to check what sort of antibiotics your doctor is prescribing. Permanent neuropathy from an antibiotic is no joke and is so easily avoided - it's in your own interests to check the label on the box and question your doctor's choice afterwards.
 

Permanent Peripheral Neuropathy
A Case Report on a Rare but Serious Debilitating Side-Effect of Fluoroquinolone Administration
Published July 27, 2014, doi: 10.1177/2324709614545225 Journal of Investigative Medicine High Impact Case Reports April-June 2014 vol. 2 no. 2 2324709614545225

Jacquelyn K. Francis, BA1
Elizabeth Higgins, MD1
1Albany Medical College, Albany, NY, USA
Jacquelyn K. Francis, Albany Medical College, 47 New Scotland AvenueAlbany, NY 12208, USA. Email: francij@mail.amc.edu

Abstract

The health risks and side effects of fluoroquinolone use include the risk of tendon rupture and myasthenia gravis exacerbation, and on August 15, 2013, the Food and Drug Administration updated its warning to include the risk of permanent peripheral neuropathy. We present a case of fluoroquinolone-induced peripheral neuropathy in a patient treated for clinically diagnosed urinary tract infection with ciprofloxacin antibiotic.

Introduction

While there has been success in recent years in decreasing the numbers of unnecessary antibiotic administrations,1 still rampant in medical practice is the inappropriate use of antibiotics. Fluoroquinolones administration is no different. These bactericidal agents are capable of central nervous system (CNS) penetration,2 with an impressive treatment profile that includes an enhanced spectrum of activity, high oral bioavailability, high serum drug concentration that parallels that of intravenous drug administration, and rapid mechanism of action. It is for this reason that physicians favor these drugs for treatment of simple infections, which range from uncomplicated urinary tract infections (UTIs) and gastrointestinal infections to lower respiratory infections and pneumonias. According to established guidelines, however, these antibiotics are recommended as drugs of last resort and for treatment of cases refractory to other safer antibiotic alternatives. Reports in recent years of the adverse drug events of these drugs are on the rise, with not only an overrepresentation of common antibiotic complaints, including diarrhea, nausea, and headache that occur at rates higher than most other antimicrobials on the market,3 but there is also mounting evidence suggesting the potential for long-term adverse peripheral nervous system (PNS) effects from fluoroquinolone usage. The need for physicians to be judicious when prescribing these drugs is therefore paramount.

Case Presentation

A 57-year-old Caucasian female presented to outpatient clinic with complaints of dysuria, polyuria, and urinary urgency. Urinalysis showed 2+ leukocytes and trace blood. Based on her clinical presentation, she was treated for UTI with a ciprofloxacin regimen of 250 mg twice a day for 5 days. Subsequent urine culture showed no evidence of organism, and against advice for reevaluation, she was lost to follow-up. She presented 2 months later reporting whole body burning and alopecia. The burning, she claimed, started 2 or 3 days after completion of the prescribed course of ciprofloxacin. The burning lasted 3 weeks and resolved only to recur, unrelentingly, 3 weeks later. She had been unable to adorn clothing during this time, for she said this triggered whole body burning. At the point wherein she was finally able to wear clothing, she presented to the clinic. Hydration and Epsom salt soaks provided no relief. She reported pain of 10/10. Her past medical history is significant for trigeminal neuralgia, in remission for 12 years. The patient was on no medications at the time of her visit. She has no specific medication allergies, but does get gastrointestinal symptoms with opioids, namely, fentanyl. Physical examination was unremarkable. Vitals at the time that she was seen included the following: blood pressure 132/78 mm Hg, temperature of 97°F, heart rate of 60 beats per minute, respirations of 18. Her body mass index was 17.94, down from 20.3 two months earlier. On detailed neurologic examination, cranial nerves II through XII were intact bilaterally. There was no pronator drift of outstretched arms. There was some muscle wasting in biceps; however, overall tone was normal. Strength was full bilaterally. Reflexes were 2+ and symmetric at the biceps, triceps, knees, and ankles. Plantar responses were flexor. Light touch and pinprick produced pain and paresthesias diffusely in the upper and lower extremities; however, position sense and vibration sense were intact in fingers and toes. Rapid alternating movements and fine finger movements were intact. There was no dysmetria on finger-to-nose and heel-knee-shin. There were no abnormal or extraneous movements. Romberg was absent. The patient’s posture was normal. Gait was steady with normal, though tentative, steps, base, arm swing, and turning. Heel and toe walking were normal. Tandem gait was normal. She had no discernable rash or skin lesions.

Subsequent complete blood work analysis to check for an electrolyte abnormality basis of her complaints was unremarkable. Her complete blood count was normal with a hematocrit of 41%. Her vitamin B12 level was 258 pg/mL, with a normal range of 200 to 900 pg/mL. Her thyroid stimulating hormone level was 2.05, with a normal range of 0.4 to 6.0. Her immunoglobulin levels were normal. Her vitamin D level was 13 nmol/L (optimal >30 nmol/L). Copper level was 98 mg (normal 50-80 mg). Vitamin E was normal at 12.7 µg/mL (normal range = 5.5-17 µg/mL). Vitamin B1 was normal at 5.4 µg/dL (normal range = 2.5-7.5 µg/dL).

Her blood work and further questioning could provide no new medical etiology for her symptoms, and so the patient was subsequently sent for complete neurological workup. Workup included heavy metal toxicity screening to assess for possible heavy metal exposure to lead, mercury, cadmium, and zinc. Electrophysiological studies were also done to assess neuromuscular nerve action potential transmission, a test that could discern a neuromuscular disorder etiology. Three-millimeter skin punch biopsy to assess for small fiber density and possible neurologic process were also done. These tests were all negative. Neurological workup could not determine a unique cause of her symptoms. It was concluded that if her symptoms were neurologic-based, it was, in fact, a multifocal process.

Two years after the initial onset of symptoms, the patient continues to suffer from polyneuropathies chronologically related to ciprofloxacin use. At her most recent visit, she describes constant pain of 7/10 and is unable, she states, to ambulate for more than 2 minutes, without intense shooting pains up and down her lower extremities. She describes “pins and needles” up and down her legs and thighs radiating to her buttocks and feet. She claims that her upper body and abdomen have now been spared of such feelings. She describes severe alopecia and ambulates now with a broad-based gait. She describes being on permanent disability because of her condition. The rest of her physical examination remains unchanged. There are no gross neurological deficits discernible on neurologic examination. The patient remains on amitriptyline 20 mg daily for control of her pain symptoms.

Discussion

Fluoroquinolones are fluorinated quinolones, the only bactericidal agent in the antibiotic class capable of directly inhibiting DNA synthesis. They do this by promoting cleavage of bacterial DNA in the DNA–enzyme complexes of DNA gyrase and topoisomerase IV.2 Generally, gram-negative antibacterial activity correlates with inhibition of DNA gyrase, and gram-positive antibacterial activity corresponds with inhibition of DNA type IV topoisomerase.2,4 With the introduction of these drugs in the 1960s, physicians were able, for the first time, to treat severe gram-negative infections orally.3 The first successful fluorination of part of the quinolone drug in 1986, in the form of norfloxacin, brought with it the capability of crossing the blood–brain barrier and achieving CNS penetration.5 This and the already great treatment profile in the form of enhanced spectrum of activity, high oral bioavailability, high serum drug concentration comparable to intravenous infusion, and rapid mechanism of action added to the popularity of these drugs ultimately resultingin the indiscriminate use of these drugs. The enhanced treatment profile of these drugs came at a price however, with adverse effects so severe that use of many fluoroquinolones since then being restricted or the drugs withdrawn from the market entirely.6,7

One of the challenges of diagnosing a patient with fluoroquinolone-associated peripheral neuropathy is the diffuse, confusing, and delayed array of symptoms that can occur. A 1996 study first brought these adverse effects to light.7 While patients on the fluorinated drugs exhibited less side effects than those associated with first-generation quinolone predecessors, such as nausea and gastrointestinal disturbances, 0.9% to 1.6% experienced adverse reactions relating to the peripheral and central nervous system, including headache, dizziness, drowsiness, agitation, psychosis, and convulsions, as well as peripheral sensory disturbances, symptoms that had never been complained of prior, at least not on any significant scale. Of these patients, 81% had symptoms occurring within 1 week of drug administration, with paresthesia being the mainly reported symptom. Five years later, a 2001 study found that contrary to previous reports suggesting that fluoroquinolone-associated PNS events are mild and short term, 80% of study participants reported severe events that typically involved multiple organ systems, especially the PNS, with symptom onset as early as 24 hours within initiation of treatment. 58% of these cases had symptoms lasting greater than 1 year.8

Another 2001 formal study that sought to assess the prevalence of fluoroquinolone-induced PNS adverse side effects highlighted the severity of these effects. The study concluded that there was a high association between fluoroquinolone antibiotics and severe, long-term adverse PNS and multiple organ system effects that included PNS sensory symptoms (91%), peripheral neuropathy motor symptoms (55%), and CNS effects (75%). Over 80% of the patients surveyed had sequalae stemming from fluoroquinolone use that lasted for greater than 1 year.9 A subset of these patients and their adverse drug events are included in Table 1.


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Table 1.

15 of the 45 Total Reported Cases of Fluoroquinolone-Associated Events in the Literature6.

Despite these seemingly significant numbers and overwhelming reports from patients, physicians continue to prescribe fluoroquinolone antibiotics unsystematically, against US Food and Drug Administration recommendations. The pressures of health care facilities and patients alike to increase patient turnaround and quickly alleviate symptoms may compound this problem 10.

As highlighted in the aforementioned case, the peripheral neuropathy reported with fluoroquinolone administration can be severe, debilitating, and permanent. It is for this reason that physicians need to practice due diligence when prescribing not only antibiotics, but any drug. Physicians also need to practice vigilance in the event of an adverse reaction. They can do this with careful follow-up of patients and ensure that patients are aware of all the side effects that may be associated with their prescribed drug. Patients need to know what to look for and where to go in the event that one of these symptoms become manifest. It is our hope that the updated FDA warning and presentation of this case will encourage physicians to be more conscientious of their treatment selections.

Take Home Points

The FDA recommends that fluoroquinolones be used as a drug of last resort and for treatment of cases refractory to other safer antibiotic alternatives.

The FDA updated their black box warnings on all fluoroquinolones to stress the rapidity of onset and permanence of peripheral neuropathy associated with their use.

Physicians should be aware of the risks and side effects associated with the drugs that are prescribed and be able to inform patients of the risks associated with the use of these drugs.

Physicians should always aim to administer the least broad spectrum antibiotic possible based on known sensitivities and regional resistance patterns.

Article Notes

Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding The author(s) received no financial support for the research, authorship, and/or publication of this article.

This article is distributed under the terms of the Creative Commons Attribution 3.0 License (http://www.creativecommons.org/licenses/by/3.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (http://www.uk.sagepub.com/aboutus/openaccess.htm).

References
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US Food and Drug Administration. FDA drug safety communication: FDA requires label changes to warn of risk for possibly permanent nerve damage from antibacterial fluoroquinolone drugs taken by mouth or by injection. http://www.fda.gov/Drugs/DrugSafety/ucm365050.htm. Accessed August 15, 2013.
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Scheld M. Quinolone therapy for infections of the central nervous system. Rev Infect Dis. 1989;11(suppl 5):S1194-S1202.
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Wolfson JS. Mechanisms of Quinolone Action and Bacterial Killing. Quinolone Antimicrobial Agents. 2nd ed. Washington, DC: American Society for Microbiology; 1993:53-57.
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Zelles T. Inhibition of rat parotid gland growth response induced by chronic isoproterenol following treatment with quinolone antibiotic. Mol Cell Biochem. 1996;165:55-63.
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Igra H. Levofloxacin-induced tendon rupture: a case report and review of the literature. J Am Board Fam Pract. 2003;16:458-460.
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EFFECTS OF CONSUMING UNNECESSARY ANTIBIOTICS REVEALED

Contrary to popular perception, researchers have found that consuming an unnecessary amount of antibiotics could lead to antibiotic resistance, a major public health concern.

There are other risks associated with taking unnecessary antibiotics, such as secondary infections and allergic reactions, the researchers said.

“Patients figure that taking antibiotics cannot hurt, and just might make them improve,” said David Broniatowski, assistant professor at the George Washington University in the US.

“More than half of the patients we surveyed already knew that antibiotics do not work against viruses, but they still agreed with taking antibiotics just in case,” Broniatowski added.

For the study, the researchers surveyed 113 patients in an urban hospital to test their understanding of antibiotics.

They discovered a widespread misconception: Patients may want antibiotics, even if they are aware that drugs will not improve their viral infection.

These patients believe that taking the medication will not worsen their condition – and that the risk of taking unnecessary antibiotics does not outweigh the possibility that they may help.

“We need to fight fire with fire. We need to let them know that antibiotics can have some pretty bad side effects, and that they will definitely not help cure a viral infection,” Broniatowski said.

The study appeared in the journal Medical Decision Making.

Fluoroquinolone Antibiotics A Danger To Neuropathy Patients

Today's post from peoplespharmacy.com (see link below) is another article warning about the dangers of fluoroquinolone antibiotics and the possibility they will lead to neuropathy (amongst other things). You will see these articles all over the internet at the moment and they were sparked off by an FDA acknowledgment that there is some truth to the problems caused by this sort of antibiotic. If your doctor unwittingly prescribes a fluoroquinolone antibiotic for a problem you may have, always question whether this is a wise choice. There are alternatives available and if you already have neuropathic symptoms, those alternatives should be explored. This article carries a warning that should perhaps not be taken lightly.

Antibiotics Avelox, Cipro; Levaquin Triggered Life-Altering Neuropathy
October 17, 2013 in Pharmacy Q and A

Q. I have taken Cipro, Levaquin and Avelox numerous times over many years. And now I am a neurological patient for treatment of neuropathy.

At first I could not understand why my feet felt like "fuzzy feet." I Googled "fuzzy feet" and that started my investigation into it. My resarch took me thru twists and turns. Finally, information on my new neurologist's website revealed that a cause could be quinolone antibiotics, including Cipro, Levaquin, and Avelox.

I suffer from neuropathy (confirmed by my doctor) in both feet. It is slowly advancing from my feet to my calf. Where will it stop? This is scary!

At first I cried uncontrollably because I realized this is a life sentence--there is no cure for it; just treating the symptoms. My insurance deductible is $2400 (up from last year $1200) and my out of pocket is $4700+ (up from last year $2500). This is another life sentence. Having neuropathy and having insurance I cannot afford is a double whammy.

Thank you, Big Pharma, for my life sentence. No money in the world can give me back my health.

A. We are so sorry to learn about the complications you have apparently suffered from quinolone (officially fluoroquinolone) antibiotics. This category of broad spectrum antibiotics is very popular with physicians because these drugs work against a variety of infections of the skin, sinuses, lungs, prostate and urinary tract. According to the FDA, more than 20 million people take a quinolone antibiotic each year. Most do well, but some experience life-altering side effects as you have.

Now sold primarily in generic form, medications such as ciprofloxacin (Cipro), levofloxacin (Levaquin) and moxifloxacin (Avelox) can indeed cause neuropathy or nerve problems. Although quinolones have been around for decades, it took the FDA until August, 2013 to issue the following safety communication about neuropathy:

"This serious nerve damage potentially caused by fluoroquinolones may occur soon after these drugs are taken and may be permanent... Peripheral neuropathy is a nerve disorder occurring in the arms or legs. Symptoms include pain, burning, tingling, numbness, weakness, or a change in sensation to light touch, pain or temperature, or the sense of body position. It can occur at any time during treatment with fluoroquinolones and can last for months to years after the drug is stopped or be permanent. Patients using fluoroquinolones who develop any symptoms of peripheral neuropathy should tell their health care professionals right away."

We suspect that it will come as a shock to many physicians to learn that the neuropathy can occur "soon after these drugs are taken" or "at any time during treatment" and can "be permanent."

In other words, some patients may experience irreversible nerve damage after surprisingly short exposure. Here are stories from other visitors to this website:


"I was prescribed Cipro for a UTI [urinary tract infection] 5 years ago at age 53. It was a 10 day Rx. Within a few days after starting the Rx I started getting migrating pains in my joints and muscles. The bottom of my feet started to burn and tingle. I couldn't stand having anything on my feet or they would feel like they were on fire. My leg muscles got so weak I couldn't stand for any length of time. There were other things too. I felt just awful.

"I called the prescribing physician, who told me these were normal side effects and would disappear once I finished the Rx. Well, it didn't. It only got worse. Over the ensuing weeks I suddenly developed arthritis in both of my hands, wrists, knees and feet. My knees crackle badly now when I bend them and feel like I have sand in them. I have to wear ortho shoes. Never had one bit of arthritis before I took this drug. My doctor would never acknowledge that Cipro may have been a factor in the sudden development of all of these problems. I went to a rheumatologist who thinks I probably have mild RA now and put me on prescription anti-inflammatories. They help.

"I also saw a neurologist. He ran a bunch of neuro tests which were all normal. He was the only one who acknowledged that Cipro could have played a factor. Now it's five years later. Some of the issues have improved. The arthritis has not improved. I'm stuck with it now for life. Needless to say, had I known about the potential dangers of this drug I NEVER would have taken it." C.B.


"Thanks to this article, I know now why I have such nerve pain in my feet and legs...I was put on Levaquin over a year ago, and suffered much pain walking...did not take the whole prescription, but enough to have done the damage, which is still giving me much pain in my feet and legs...and I see now that this affliction will most likely be with me permanently...have told my doctor right away about this pain. She said that it sounded like tendonitis, but did not admit to me that it was mostly likely from the Levaquin she prescribed..." K.E.B.

Some people suffer more than neuropathy. Many patients report tendon problems such as tendinitis or even tendon rupture. Other complications include retinal detachment, hallucinations, depression, anxiety, agitation, confusion, headache and dizziness. To read more about the side effects of drugs like Cipro or Levaquin, here is a link to a more complete overview.

Here are some additional stories:

"OMG! Hallelujah! An article that I can finally bring to my doctors which they just might read!

"I have been suffering for over 16 years. No doctor believed it has stayed in my system for so long. I have every side effect you mentioned. Then unfortunately after staying away from this class of drugs for 16 years, my surgeon felt that the Floxin solution she put in my head during a nerve decompression would not harm me. She was quite wrong. I have been so very sick since then and I am much older now so it is harder to convince doctors that it is not my age.

"Every bone, muscle, tendon and nerve hurts. My panic attacks came back full force and my eyes are so blurry. Brain fog, memory problems and trying to finish a sentence is disturbing as well. My stomach problems are worse than ever.

"Thanks for the article. Us 'Floxies' appreciate it!" Sherry

Sherry's reference to "Floxies" refers to the "floxacin" part of the name of ciprofloxacin or levofloxacin. Many years ago the journalist Stephen Fried wrote a compelling book about his wife's experience with a quinalone called Floxin. He described the hallucinations and neurological damage as being "floxed."

Here is one more story which demonstrates that the complications can come on suddenly, after only a few pills:

"It takes the FDA too long to take notice of dangerous drugs! Four years ago, my 70 y/o husband took only two of five prescribed tablets of Levaquin for bronchitis. After only two tablets, he experienced severe pain in both calves and became motionless at the bottom of the stairs in our home. I suddenly remembered the 80 y/o husband of a friend who had just severed his Achilles tendon after long term use of Cipro in the treatment of prostatitis; his recovery was excruciating. Fortunately, my husband recovered after enduring several months of pain.

"There actually was a new black box warning on the danger of ruptured tendons which went unnoticed by both our geriatrician and pharmacist. Our doctor said he had never had a bad experience with Levaquin which he mentioned to a fellow racket ball player. Interestingly, his friend actually had experienced such a ruptured tendon. As the Graedons have stated, such a relationship to antibiotics often goes unnoticed.

"This new black box warning of potential nerve damage is far more devastating and has ruined many, many lives; just do a Google search for some terrifying stories.

"Levaquin originally was developed to be used as a last line of defense against dangerous and stubborn bacteria instead of as a first drug of choice by too many doctors. Some people just have a sensitivity to these dangerous antibiotics. My husband could tolerate cipro some time ago but not the levaquin. It's really a game of Russian roulette with potentially devastating possibilities!" Sal W. 

We know that many people have taken quinolone antibiotics successfully and experienced few, if any, side effects. But some, like those who commented above, have experienced tragic consequences. Everyone who takes such drugs should know what side effects to be aware of before taking the first pill. There is more information at this link. 

http://www.peoplespharmacy.com/2013/10/17/antibiotics-avelox-cipro-levaquin-triggered-life-altering-neuropathy/

COMMON ANTIBIOTICS LINKED WITH HEART DEATH

The antibiotic clarithromycin -- widely used for treating common bacterial infections -- is associated with an increased risk of heart deaths, finds a study published on thebmj.com today.

The authors say their findings require urgent confirmation, given that many millions of people are prescribed the drug each year. But they stress that the absolute risk is small and that prescribing practice should not be changed until results have been confirmed in an independent study.

Clarithromycin belongs to a group of antibiotics known as macrolides. Macrolide antibiotics prolong the duration of electrical activity of the heart muscle (known as the QT interval) and are therefore thought to increase the risk of potentially fatal heart rhythm problems.

Given this background, the cardiac safety profiles of individual macrolides need to be studied in greater detail to help guide clinical treatment decisions.

So a team of Danish researchers decided to assess the risk of cardiac death associated with clarithromycin and another macrolide called roxithromycin, compared with penicillin V, an antibiotic with no known cardiac risk.

Using national databases, they identified over 5 million treatment courses among Danish adults aged 40-74 years from 1997 to 2011 (160,297 with clarithromycin, 588,988 with roxithromycin and 4,355,309 with penicillin V).

Individuals with serious disease, who may be at high baseline risk of death, were excluded from the analysis.

A total of 285 cardiac deaths were observed during ongoing use with the study drugs, 18 of which occurred during use of clarithromycin and 32 during use of roxithromycin.

After adjusting for factors such as age, sex, baseline cardiac risk and use of other medication, ongoing use of clarithromycin was associated with a 76% higher risk of cardiac death compared with use of penicillin V. There was no increased risk of cardiac death with clarithromycin after treatment had ended.

The absolute risk difference was 37 cardiac deaths per 1 million courses with clarithromycin. No increased risk of cardiac death was found with ongoing or past use of roxithromycin.

"Our study expands on the available knowledge of the cardiac safety of macrolides, being the first large scale population based observational study to show significantly increased cardiac risk with clarithromycin and the relative cardiac safety of roxithromycin," write the authors.

The authors emphasise that the absolute increase in risk is small and should have limited, if any, effect on the prescribing practice in individual patients. However, they note, "clarithromycin is one of the more commonly used antibiotics in many countries and many millions of people are prescribed this drug each year; thus, the total number of excess (potentially avoidable) cardiac deaths may not be negligible."

Before these results are used to guide clinical decision making, "confirmation in independent populations is an urgent priority given the widespread use of macrolide antibiotics," they conclude.

Neuropathy And Fluoroquinolone Antibiotics Dont Mix!

Today's post from naturalhealth365.com (see link below) returns to an old chestnut on this blog that remains relevant because of the increasing numbers of people ending up with nerve damage due to use of fluoroquinolone antibiotics. These really are antibiotics with a sting in the tail and it can be some time before the side effects appear but if you have an infection and are prescribed antibiotics by your doctor, check that they don't belong to the fluoroquinolone group (a list of common brand names appears in the article), especially if you already have, or are prone to neuropathy. There are always alternatives and you should seriously discuss these with your doctor. Further articles on the subject can be found by using the search button to the right of this blog. If in doubt, remember that the American FDA doesn't issue warnings aboiut drugs lightly - they certainly warn you about fluoroquinolones!

FDA warns that fluoroquinolone antibiotics can cause permanent nerve damage 
Posted by: Lori Alton, staff writer in Drug Dangers July 10, 2016

(NaturalHealth365) The U.S. Food and Drug Administration recently came out with a stronger warning against a popular class of drugs called fluoroquinolone antibiotics. Unfortunately, this warning is too late for patients already suffering from permanent side effects caused by this dangerous category of antibiotics.

Sold under the brand names Levaquin, Cipro and Avelox, fluoroquinolone antibiotics are taken by an estimated 26 million Americans each year. The new FDA directive will force manufacturers to provide a stronger warning regarding their use. Keep in mind, when the FDA issues a warning, you know the drug is really toxic and dangerous.
FDA warns: Fluoroquinolone antibiotics offer ‘serious side effects’ which outweigh the benefits

In May, the FDA announced it was requiring manufacturers of these drugs to include a tougher black box warning. Following an advisory committee meeting held in November, the FDA issued the new requirement, warning that the agency now believes the serious side effects associated with fluoroquinolone antibacterial drugs outweigh the benefits for many patients.

That’s strong language coming from an agency that often seems to turn a blind eye toward evidence suggesting serious health risks associated with any pharmaceutical substance. The agency had previously added boxed warnings for fluoroquinolones back in 2008 – specifically for tendon rupture and tendinitis. A second warning came again in 2013 for peripheral neuropathy, a type of permanent nerve damage.

Adverse reactions to fluoroquinolones can lead to permanent damage

While the list of dangerous side effects of Levaquin and other fluoroquinolones is long and varied, these antibiotics are known to be a primary cause of peripheral neuropathy. This condition can lead to nerve damage, with symptoms such as muscle tingling, numbness and muscle weakness. In advanced cases, the condition causes persistent burning pain, muscle wasting, paralysis, respiratory issues, and organ dysfunction – which can lead to organ failure.

But that isn’t the entire story. A number of additional adverse reactions to the drugs have been identified over the years, including diarrhea, nausea, migraines, abnormal liver function, vomiting, skin rash, abdominal pain, and pain in the extremities. Fluoroquinolones have also been linked to cardiovascular problems, including palpitation, ventricular ectopy, atrial flutter, hypertension, angina, cerebral thrombosis, myocardial infarction, and cardiopulmonary arrest.

In addition to an alarming number of problems with the central nervous system, these antibiotics are known to cause gastrointestinal, musculoskeletal, renal and respiratory problems, among others. And, while many of the fluoroquinolones have been removed from the marketplace because of their substantial side effects, Levaquin, Cipro and Avelox remain in use. 

Other treatment options avoid use of antibiotics entirely

While the FDA’s warning recommends patients with bronchitis, uncomplicated urinary tract infections and sinusitis seek out other treatment options, the implication is still that those ‘other options’ should include antibiotics or similar medications. But in addition to risking horrific side effects, the use of any antibiotic puts healthy gastrointestinal microbes in danger, compromising the body’s natural immune system and leaving it open to cancer and other illnesses. Destroying healthy bacteria in the gut also leads to poor nutrient absorption.

But, in reality, there are safer alternatives to antibiotics. Among the most effective (natural) alternative are vitamin C, oregano oil, olive leaves, turmeric, garlic, and ginger. Another natural combatant against illness is to maintain a healthy immune system by maintaining a healthy body.

Never forget: Good health begins with great nutrition. Be sure your diet consists of natural, organic and GMO-free foods, with plenty of green, leafy vegetables for a natural, healthy immune system.

Editor’s note: To learn more about the healing power of vitamin C – read “Reversing disease with the multi-C protocol” by Thomas E. Levy, MD, JD

References:

https://www.drugwatch.com/2016/05/16/fda-black-box-warning-for-levaquin-cipro-antibiotic-risk

http://www.naturalhealth365.com/side-effects-of-cipro-fluoroquinolones-1440.html

http://www.naturalhealth365.com/fluoroquinolone-antibiotics-1896.html