Dangers of Fluoroquinolones
Cipro and Some Other Antibiotics Can Cause Severe Adverse Reactions
Sep 5, 2008
Fluoroquinolones are a class of antibiotics used to treat many kinds of infections, such as respiratory infections and urinary tract infections, including prostatitis. Like all drugs they have side effects, but they appear more likely than antibiotics of other classes to cause severe, permanent adverse effects.
Antibiotics are only supposed to affect bacteria, not our own cells. Most side effects of antibiotic therapy are caused by the reduction of beneficial bacterial flora in the intestine, which can lead to nausea, diarrhea and stomach upset. Allergic reactions are also possible, as with all medications.
Unique Side Effects
Fluoroquinolones, however, are well-known for their ability to block GABA receptors in the brain. Gamma-aminobutyric acid is a major inhibitory neurotransmitter and most sedative drugs (and some anticonvulsants) either increase the levels of GABA or simulate its actions. Blocking the GABA receptor can lead to psychosis, depression and even seizures. Fluoroquinolones can also damage the tendons.
Many drugs in the class have been withdrawn from the market because of adverse effects. Some examples of fluoroquinolones still on the market include:
- ciprofloxacin (Cipro, Ciloxan)
- gatifloxacin (Tequin)
- levofloxacin (Levaquin, Tavanic)
- lomefloxacin (Maxaquin)
- moxifloxacin (Avelox)
- norfloxacin (Noroxin)
- ofloxacin (Floxin, Tarivid)
Not all of these medications are available in all countries and brand names may vary.
Long-term Disability
In some people the side effects are even more serious. Fluoroquinolones can cause long-lasting, even permanent damage, including symptoms like neuropathy (nerve damage) which may lead to severe pain. It is impossible to predict who gets this reaction, but corticosteroids (like prednisone), NSAIDs (like ibuprofen) and caffeine may increase the risk and should not be combined with fluoroquinolones.
Some people who have been damaged by fluoroquinolones - they often call themselves "floxed" - have extensive disability, with problems like fatigue, muscle weakness, cognitive problems, neurological symptoms, cardiac arrhythmia, hearing loss, rashes, headaches, anxiety, tremor, and extensive pain. The resulting illness may resemble fibromyalgia and CFS/ME. For many, it is a living hell.
Some of the affected appear to recover from this reaction in a few weeks or months, but others may be left with permanent, devastating disability. It is difficult to prove that the symptoms are caused by the drugs, as most doctors aren't aware of such severe reactions and the companies manufacturing them are not keen on admitting the problems.
A paper published in a medical journal in 1996 suggests that symptoms of "floxing" may be ameliorated by gamma-hydroxybutyrate (GHB), also known as sodium oxybate. This medication is available in the United States and some other countries as the sleeping aid Xyrem, but it is officially only approved for narcolepsy and is very expensive. The muscle relaxant baclofen (Lioresal) may act in a similar fashion.
Risks vs. Benefits
All antibiotics can be life-saving medications. Different antibiotics work against different bacteria, and often bacteria are resistant to one antibiotic but not to another. In case of a serious infection that cannot be treated with other drugs (or has not responded to them) fluoroquinolones may be necessary. In that situation the benefits would outweigh the risks, as untreated the infection might be life-threatening.
In many cases, however, fluoroquinolones are used for infections which could be treated with other antibiotics, or may not require any drugs at all. In such a case one can discuss with one's physician whether it is possible to use a different type of a drug - or whether it is safe to wait and see if the infection clears up on its own.
References
Dimpfel W, Dalhoff A, von Keutz E. In vitro modulation of hippocampal pyramidal cell response by quinolones: effects of HA 966 and gamma-hydroxybutyric acid. Antimicrob Agents Chemother. 1996 Nov;40(11):2573-6.
