As an older person who lost her spleen in 2012 (surgical error during colonoscopy) what am I to do when I am prescribed antibiotics “in case” whenever I get so much as a simple cold? I fear that levaquin (used twice, both times in the emergency room) has given me a permanent case of tendinitis. What antibiotics are safest for elderly people who are somewhat immune compromised?
10
How about removing them from the accepted list of Medicare drugs. The incidence will go down dramatically. By observation alone, medicare seems to pay for too many unnecessary procedures. I recall a couple who went to their dermatologist the minute they were eligible and a very fancy screening procedures was done instead of a simple review to look for signs of skin cancer.
4
My mother is going to be 87 this spring. I worry every time the doctor prescribes any medication for her. When she was younger she never suffered any of the side effects. Once she reached her late 70s she began to experience some of them. But when she questions the doctors they don't come up with alternatives. They don't do any tests to see if the antibiotics are warranted. They just prescribe. Except in one case: this summer she had Lyme disease again. The doctor didn't prescribe even though my mother brought in the offending tick. She went through half the summer feeling horrible until the test results came back. The summer before the doctor hadn't hesitated.
I'm not a fan of throwing drugs at every problem. I am a fan of being allowed to take time off to recover from an illness. I'm a fan too, of having doctors spend more time with their patients so they get to know them: who can tolerate pain and who cannot, who is prone to severe illnesses requiring antibiotics and who is not, who experiences side effects and who escapes them. Our current health care system has no continuity of care. Walk in clinics are not a substitute for having a regular physician.
Antibiotics, pain killers, cough medicines are not substitutes for time off to recover from an illness. If we weren't so frightened of losing our jobs at the slightest excuse we might make use of our sick time and get well.
25
Same thing happened to me. Had a huge bullseye on my thigh and the refused to prescribe doxy. Went to another doctor he immediately put me on a 2 week regiment.
6
While every health care professional includes a minority of outliers whose clinical practices do not conform to recognized standards of care, or are outdated, it is the logical fallacy of hasty genetalzation to state that this tiny minority is typical of the entire dental profession.
The American Dental Association has collaborated with medical professionals in the American Heart Association and the American Society of Orthopedic Surgeons to develop and publish scientifically based joint consensus statements on the use of antibiotics for patients with cardiac conditions, artificial blood vessels, artificial heart valves, and prosthetic joint implants. With advances in clinical sciences the scientific literature changes, resulting in periodic revisions of published national standards for use of antibiotics to protect patients with certain medical conditions.
This article states: "Getting this right will mean breaking longstanding habits among providers, including dentists (who may unnecessarily tell patients to take antibiotics before appointments if they’ve had certain surgeries)."
The statement unfairly and inaccurately reflects current dental practice and published evidence-based standards of dental care . It inequitably maligns dentists who have extensive education in pharmacology in dental school as well as during advanced post-doctoral education in general dentistry or dental specialty training who keep abreast of advances in clinical care.
4
The exact same dangers were being warned about when my children were young - 30 years ago. I didn't give my kids antibiotics, and they still have strong immune systems, compared with the sickly people who take antibiotics for every cough and sniffle. So today the CDC estimates that 124,000 people die every year because of antibiotic overuse!! And at this rate, affordable antibiotics soon won't work. Meanwhile, people are hysterical about several hundred deaths from measles. Where is the hysteria about this huge and escalating public heath issue?
5
Wash your hands. Wash them with soap and water for at least 1 minute. Watch a YouTube video on hand-washing just to make sure you're doing it properly. Make sure everyone in the house has their own hand towels and that all hand-towels are hung on separate hooks. Change the towels for new clean ones at the end of every day. If using bar soap, then everyone should have their own. This is easy if you just arrange towel color and hook color by personal preference.
I found that after my children left home they became more careless about hand washing. When I married my husband, I was retired, he told me "I've noticed you wash your hands every time you leave the bathroom or come in from outside, before we eat, before you handle food, and take a complete shower after a doctors visit. I should probably do the same, but I never thought about it until I noticed you." Well, I am sick less than anyone else I know. I attribute it to hand washing.
Don't misunderstand me. I do not keep a sterile house. I don't dust and vacuum every day. The Pope certainly should NOT eat of any area of any of the floors. But I did find that hand washing kept me well which was absolutely vital as a single parent of 3.
14
I have taken Cipro through my life on three or four occasions. It did what it was supposed to do, which was cure an infection. I did not have side effects as others are describing.
It is important that this drug can be useful for people and should NOT be taken off the market.
Yes, be cautious.
But honestly, it helped me. No side effects. Glad it did.
4
Sadly, drugs made people believe nursing and resting had become superfluous. There is no time to convalesce, let alone take care of others. Nobody can stop, not even the elderly who often work or help their grown children.
If you cannot rest, if nobody can take care of you when you are sick, antibiotics and painkillers become necessities. It is not just a medical problem: the receptionist whose cough prevents her from answering the phone, or the cashier with a urinary infection and rare bathroom breaks may well convince a doctor to prescribe antibiotics, their jobs are at stake. Sure, drinking plenty of fluids and resting may have done the trick, but it wouldn't have paid the bills, least of all the doctor's.
I think the relationship Americans have with drugs have complex societal explanations, and that physicians cannot solve the problem all by themselves.
15
Your gut doesn't like this stuff and it tells you so. Cipro, Septra, Keflex, Zmax and their brothers are off limits for me. I am not allergic, but after 5 or 6 days, I am nauseated and my liver starts going wacky. There's one antibiotic I took that addled my brain so that i walked away from the TSA screening line leaving my suitcase sitting there...and I'm a frequent flyer. That's scary. I am the opposite of those patients who ask for antibiotics. I'd rather do without, or do fewer days if i can. I take probiotics along with the antibiotics to keep my gut halfway healthy.
9
Last September, I was diagnosed with bronchitis, prescribed the generic version of Levaquin, despite the doctor having been warned by the drug company that it should not be given to patients over 60. I was 68.
The day after Thanksgiving (two months later) the large tendon connecting my thigh muscle to my knee in one of my legs spontaneously ruptured ('exploded' was the term my ortho surgeon used). Two days later, the same thing happened to my other leg. I went from being healthy and in good shape to being wheelchair bound in two days.
Operated on in January, I have been going through the hell of physical therapy and learning to walk again as my thigh muscles lost all their strength for a while.
And there are psychological repercussions. I worry about other tendons in my body rupturing, I panic slightly at having to go down steep stairs. There are moments when it suddenly feels like my legs are about to give out. They are not, but that doesn't make it any better. I spent a month in restraints that kept my legs absolutely straight 24 hours a day. Try sleeping that way, on your back, for a month.
The only thing that saved me from being permanently crippled was excellent health otherwise, great upper body strength, that I was active before the ruptures, and that I was determined to walk again.
Tens of thousands of cases very similar to mine, and Big Pharma has apparently seen to it that the FDA does nothing.
LEVAQUIN/LEVOFLOXACIN continues to be dispensed to the unwary.
27
Ms. Span's article may encourage people with asymptomatic infections to refuse antibiotic treatment. Yet just because a bacterial infection is asymptomatic does not necessarily mean it should not be treated. A case in point would be Helicobacter pylori infection, often asymptomatic, but which accounts for more than 60% of cases of stomach cancer.
3
One of the interesting factors in drug prescribing is that doctors are now being trained by the pharmaceutical companies. These companies lobby doctors like used car salesman. They tell the doctors what symptoms their drugs cover and tout the efficacy of those drugs. Doctors are no longer thinkers but seem to run their practices based on algorithms partially because of the guidelines and restrictions placed upon them by insurance companies who are basically interested in how much money they can make. It is time for universal health care which means we have to shift our thinking from trying to rule the world through military might to thinking about peoples well being in general. When we can make that shift there will be plenty of money to care for all of us and perhaps many will feel good about paying taxes.
9
After I developed a urinary tract infection from a prostectemy I was prescribed Cipro, for a week. A few days into taking it, I read the label. I was stunned when it said it makes you prone to tearing a tendon, particularly those with a past history. Bingo!
I had torn both my achilles tendons years earlier. I started feeling tingling and was unsure if it was psychosomatic or real. I raced up to Weschester to see the surgeon who had performed both operations. He calmed me down but agreed I should've never been put on Cipro.
Clearly, a mistake was made by the admitting urologist where I had gone to be treated. I'm lucky that so far my tendons have not torn again. Also the Cipro made me nauseous. Never again.
7
two tounds of Cipro, I protested taking Cipro for a uti, i ended up in a mental health facility, outpatient
2
I was just made aware of the peripheral neuropathy link to Levaquin on Friday , when I ran into a gentleman I’d never met before who shared his story with me. He told me he had his physical and mental health shattered by taking one pill, just one, for a chronic sinus infection years ago, and he immediately felt poisoned and is still to this day suffering from it. It had visibly destroyed his ability to live a healthy and happy life. Absolutely terrifying a consequence could be so severe and so long lasting from a dose or two.
9
You had a chance conversation with a stranger about how a single tablet of antibiotics ruined his whole life, and now you are so satisfied with that explanation that you feel the information is fit to print in the New York Times?
One would think that this recent anti vax campaign has taught us a thing or two about the danger of rumor mixing with medicine. We should work harder to recognize that patients are incredibly vulnerable, perhaps as much so to irresponsibly magnified pop culture misinformation as they are to disease.
6
I was diagnosed with a severe kidney infection in the end of October. Within a few days of starting Levofloxacin I starting having pain in both of my Achilles’ tendons, to the point where it was difficult to walk. The doctor prescribed it despite knowing that I’m over 60 and am taking prednisone. It’s taken months of therapy to be able to walk without pain and it severely impacted my ability to stay fit. Fitness and stamina are quickly lost and only regained after a tremendous amount of work. Never again!
11
I haven't taken antibiotics since the late 70's and I just turned 65. I rarely get anything more than an occasional cold every few years.
I read some very negative things about them back them. Although it has gotten better, it still shocking to hear that they continue to be overused.
It really makes use question the wisdom of some doctors.
9
Splendid article by Paula Span. Antibiotics are serious medicine prescribed too often and sometimes for the wrong reasons. They can be harmful to health. Prescribers AND patients need a boost to their awareness of toomuchness and why. Extra consideration for older patients. Very helpful info here!!! Rethink antibiotic use -- caution warranted! Many reasons to know more...
Not every pain needs a pill.
7
I get acute bronchitis more often than I like. I do not take antibiotics, but when the article says just a few more days, mine take six weeks. It gets old, but I don't bother my doctor. As far as I know there really is nothing they can do about bronchitis other than to just wait it out and rest. It is likely that many doctors feel pressured to do something so they just prescribe antibiotics.
9
The AMA motto: "We have a pill for that."
12
ALL drugs have potential side-effects, some far more than others. Cipro has a lot of bad ones, but may still be the antibiotic-of-choice by a doctor for some infections.
I cannot take it - I've had two adverse reactions - one to Cipro and one to Levaquin (a related drug). It's too bad I can't - they work very well on gram-negative bacterial infections and I have a chronic one along with my bronchiectasis.
In the end, if one doesn't ask why a particular drug is being prescribed, then shame on the patient. We must be our own advocates. But this does not mean insisting on a specific drug or going against what our physician prescribed due to "something we read on the internet".
Find a physician you trust. Develop a good relationship. Ask questions and follow his orders. He is not prescribing a particular drug in order to meet a quota and go on an expensive trip (a story I've heard repeatedly from ignorant people).
Also, don't decide that just because of this article, one should no longer take antibiotics. Many people need them, especially the elderly with chronic conditions. I have been questioned as to why I take Zithromax 3-times weekly. I do so as it's part of the "standard of care" for those with bronchiectasis and pseudomonas. Yet, I have been questioned in the ER or walk-in clinics multiple times and actually "scolded". I trust my doctor - he is a full-professor at our local med school and a highly respected man. He knows what he's doing.
7
@India
The thrice weekly Azithromycin is indeed nearly standard of care for bronchiectasis and may soon become SOC for COPD with chronic bronchitis or COPD in current smokers, probably having more to do with anti inflammatory effect in bronchial lining than with its antibiotic effect, though that’s not entirely clear.
3
I have MS, & despite the commonality of UTIs in MS, I’ve never had symptoms of one. My neurologist wanted me to see a urologist because it had been a couple of decades since I’d seen one. Since then, a couple of times, while undergoing testing at the urologist, I’ve been told that I have a UTI & she puts me on an antibiotic. No more! Finally, someone said it isn’t necessary. It never made sense to me that I had some kind of infection, but felt fine. I certainly had no idea that antibiotics could be so dangerous. (I’m a CPA & my knowledge of medicine is limited.)
6
This section of The Times routinely presents articles lamenting the fact that so many Americans attempt to use supplements and natural foods in an effort to ward off disease.
Perhaps now the editors will now better understand why so many Americans seek alternative routes to wellness.
16
Best medicine for growing old? Laughter, not antibiotics. Sorry doc...find another sucker for your drugs.
10
Would these be the same "older Americans" who say, "I know my body" and "My doctor always gives me..." and "I won't get better until I get..."?
Just asking.
Because if they are, my position will not withstand the fusillade of bad patient reviews that would be generated if I denied these "older Americans" the antibiotics that they demand with exactly the same urgency that drug addicts demand opiates.
If you want physicians to practice medicine in the best interests of their patients, regardless of what those patients think they want, then eliminate patient satisfaction surveys and let us get back to telling people hard truths that they would prefer not to hear, as we were trained to do.
95
@EricPatient satisfaction surveys provide cumulative information about very bad doctors. Yes, there are some. Including those who overprescribe, those who don't listen to patients, those who mis-prescribe and those who go for the money rather than a patient's best interest.
when you suggest elimininating patient satisfaction
5
@simon rosenthal
"Patient satisfaction surveys provide cumulative information about very bad doctors."
Utter nonsense.
Patient satisfaction surveys show how happy or unhappy patients are with a doctor. They have been proven to have no relation to the quality of care provided. You can have an unhappy interaction that is good for you, or a happy interaction that is bad for you (such as one in which opiates are inappropriately prescribed).
The one thing that satisfaction surveys do do is to provide administrators with ammunition they can use to harass or fire doctors who are otherwise doing their jobs well, which is why they will be with us for some time to come.
13
"as infectious bacteria adapt to the medications".... this is a common misunderstanding. Bacteria don't adapt or evolve in response to the presence of an antibiotic. What happens is that bacteria with a pre-existing random genetic mutation -- sometimes acquired from another bacteria or even another bacterial species -- can survive the antibiotic. In this way, the antibiotic inadvertently selects for the bacteria with the mutation(s) that let them survive the drug.
While I agree that fluoroquinolones have been way overprescribed, they do have their place and do work extremely well on certain infections. The key is they should not be prescribed casually, and not for uncomplicated urinary tract infections, acute sinus infections and other common infections. They definitely should not be prescribed for asypmptomatic bacteriuria -- no antibiotic should be prescribed for that.
24
In this story, the first question is, Why in God’s name did her doctor run a “routine” urinalysis on someone without underlying disease and without symptoms? The first step in overtreatment is unnecessary, inappropriate testing. There is no such thing as a risk-free test, as this example shows, and unless a test has demonstrated value (especially for screening) it shouldn’t be done. We will never get past the problem of treatment side effects unless we become clear about why every test is run, and whether the benefits of the test outweigh the risks. This takes a realignment of how both doctors and patients often think (“more is better”) and a willingness for the doctor to take time to really think things through before ordering any test.
30
@David Chakoian was also my first thought.
1
@David Chakoian...a routine urinalyis is non invasive. All that a patient does is pee in a cup. Harmless.
5
This isn’t correct, for exactly the reason described in the article. I’d encourage you to go back and re-read the section on asymptomatic bactiuria. It is a basic principle in medicine that you don’t do a test when you don’t need the test result to make a decision.
Or, I donno, maybe we could just leave this up to people who went to medical school and residency. Crazy thought.
3
Many descriptions of fluoroquinolone tendon injury are due to the singularity of this disabling but uncommon side effect. But what we see in geriatrics far more often is toxic delirium due to these drugs. They should not be used for those with dementia unless there is no alternative. Most troubling of all is prolonged manic decompensation when they are given to those with bipolar disorder.
Yet every week I face daughters who are determined to get antibiotics for their mothers in skilled care for dementia when they have a change in mental status. Too much medical care is bad for you, I tell them, pointing out how pediatricians overprescribed penicillin when we were young, and how our children and grandchildren do fine without it. In elder care, less is truly more
37
Why only daughters, not sons?
1
@Marie
He's describing his experience. Lay off.
2
This retired RN adds: I agree fully with not treating asymptomatic bacteria in urine...but don't understand why a urinalysis was part of annual screening to begin with. In absence of signs and symptoms of UTI, there's nothing worth workup that otherwise wouldn't show up.on the blood work.
28
MD here . What about asymptomatic microscopic hematuria as an early sign of bladder cancer?
8
...I mean, aside from the fact that the specificity is near zero, literally nobody recommends u/a as a screening test for this disease, and screening for bladder cancer hasn’t been shown to confer any survival benefit? Those are pretty good reasons, I’d think. (Also a MD)
The backlash.
My husband is a cancer survivor with no apparent immune system left. Every upper respiratory infection in the last two years has led to pneumonia.
On the cusp of yet another secondary infection a physician last winter, hip to the party line and apparently ignorant of the fragility age and cancer brings, denied him the antibiotics he needed to curtail yet another round of pneumonia.
11
I get my teeth cleaned every 3 months alternating between a regular dentist and a periodontist. Because I had a hip replacement 10 years ago both offices always ask if I took my penicillin before they do the work. I am 69 and know that a triple dose of penicillin every 3 months is not a good idea. I am also aware that the use of penicillin as a prophylaxis is no longer the standard for hip replacement dental patients. So I have to lie each time. But alas if I did tell the truth I would be sent home without my cleaning.
20
Be careful! My grandmother got an post-hip replacement infection from a dental visit. Three months in the hospital, endless procedures, and nearly died. It’s a marvel she came through it all. Food for thought.
3
Antibiotics, like all medicines, are simply tools to do a job. One does not pound a nail with a screwdriver just because one is holding a screwdriver in their hand. One does not leave the nail half-out and when the nail is pounded in securely, one puts the hammer away. One does not use antibacterials (which are what antibiotics really are) for viruses...but people think "infection" and push for antibiotics (using screwdriver for nail). Even when there is a bacterial infection, they often take them until they feel better and stop, even if the prescription was for longer (nail left half out). Either way leads to resistant bacteria and long-term harm to all by way of unnecessary cost of treatment, treatment of complications and resistant bacteria ("super bugs").
I would love to hear ideas on how to educate people or be able to prime them to understand that antibiotics are inappropriate for anything but a specifically targeted bacterial infection and that taking them for anything else, and taking them inappropriately can do great harm.
Would also love to see Big Pharma's ads replaced by PSAs on this topic.
18
I was so cavalierly prescribed a Cipro before every intercourse to prevent reoccurring UTIs. I switched my MD. Can you imagine?
6
The single reason why Cipro and other Fluroquinolones are still on the market with only "Black Box" warnings is that there are no real alternatives to these drugs. First, they are very highly efective broad-spectrum antibiotics, with very few bugs that have developed resistance to them over these last 25 years, secondly, they are rather cheap in comparision to the few new antibiotics on the market today. I've been directly affected by Cipro and others. I had C-Diff 3x. The first two happened within 6 weeks of each other, the second time put me in the hospital with 104F fever and resulted in serious colon damage. The last time I had developed severe pain in my knee, right elbow tendon and right gluteal tendinopathy. Never again with those drugs!!! You can read about all the class action lawsuits against the manufacturers of these drugs online , there are many. This is strictly the drug companies fault for being concerned about making huge profits instead of making a smaller but decent profit by doing R&D and having enough antibiotics on hand for the general population. Congress tried to intervene lamely, by offering them an extra years worth of patent protection before the drugs go to generic status. Time to remove tax breaks , put them in a higher tax bracket if they refuse to develop and market new antibiotics. Those are better incentives in my view.
7
Cut back on prescribed Antibiotics by all means. At the same time antibiotic use in the Agricultural industry must also be addressed. Antibiotic Resistance is a Global problem.
13
My frail elderly mom was given antibiotics — pretty sure it was in this family of drugs mentioned — to help a wound heal and, they did nothing but make her very sick and then bother her long after she was done with the course.
I think this information is spot on. Make sure your doctor is up on the over use of antibiotics and if it is REALLY needed. Consulting a gerontologist is not a bad idea too.
Apparently, most UTIs clear up on their own. But the pain killer is welcome for sure!
2
I was prescribed Levaquin for pneumonia in 2017 after another antibiotic had failed to keep bronchitis from progressing to pneumonia. Yes, Levaquin gave me a breakthrough seizure (I have epilepsy and knew a seizure was possible.) but on the other hand, my options were limited. And within 24 hours my fever of more than a week was gone.
1
Great article, but a few points that need to be corrected.
When you write "older antibiotics like Bactrim, Septra and Macrobid are " first line for uncomplicated UTIs- this is incorrect. First of all, Bactrim and Septra are the same drug - trimethoprim- sulfamethaxole., not two distinct antibiotics. Second, macrobid is first line for young adults with UTIs, not older adults. Macrobid is contraindicated in patients with low GFR (renal function) and generally avoid if there is a question of renal function with increasing age. Additionally, Macrobid is bacterial static, not bacterial-cidal- meaning that it may suppress but not cure your infection.
Furthermore, the article should distinguish between complicated and uncomplicated UTIs. There are many factors that make it much more likely that an older adult will have a complicated UTI. This of course, changes the recommendation for which antibiotic to use.
That being said, I try to avoid prescribing Cipro whenever possible. However, because of multi-drug resistant bacterial from antibiotic overuse, it is sometimes necessary.
A better first line antibiotic is Cephalexin.
6
A few months ago I had cataract surgery. Cipro was on my list of medications to which I am allergic. The surgeon questioned me about why Cipro was on the list. I couldn't remember, and ultimately I agreed to the use of Cipro. Since then, I have experienced peripheral neuropathy in my hands, unbearable pain in one large toe, foot dragging, and regular muscle spasms at night. If I hadn't read this article, I wouldn't have known to associate these symptoms with Cipro. I attributed them to not drinking enough water. Also, if the article hadn't prompted me to look up neuropathy on the Mayo Clinic website, I wouldn't have learned that it's important to get medical attention to prevent further damage!
I'm going to forward this article to the eye clinic.
14
@beberg
Why prescribe Cipro for cataract surgery?
3
On the topic of crazy antibiotic use... Back in the '90s, I lived in Singapore. I was visiting my doc for a nasty coral cut infection in my foot I'd picked up surfing in Indonesia. He asked a bunch of questions about how I got the injury, then he asked, "Do you take antibiotics preventatively?"
"Hell no!" I laughed. "Who would do such a moronic thing?"
He answered that many Singaporeans did. That they believed it gave them better immunity. I sat there with my jaw on my lap while he told me all about it. It had started back in the day when you could walk into a pharmacy and buy any drugs you wanted without a prescription.
A certain cohort had been popping them like vitamin C ever since.
He said it was why you'd see so many locals with brown teeth -- from parents prescribing their kids tetracycline.
Lots of patients asked him for antibiotic scrips. If he refused, they might switch docs.
He also told me the flus, colds and other viral infections -- in particular, in offices -- were getting crazier every year. All these mad antibiotics eaters messing with herd immunity on a grand scale.
The Singapore gov't had campaigns to get people to stop feeding pigeons, stop littering, stop spitting, remove standing water, be more polite, have more babies, flush public toilets and it infamously banned the sale of chewing gum -- but never once did I ever see a "Let's Not Take Antibiotics Preventively" day.
I wonder if it still goes on. Any Singaporeans here care to weigh in?
5
I was prescribed a quinolone called Levaquin for some spurious Lyme disease diagnosis. One hour after taking each dose, my brain would become deeply depressed and start producing suicidal ideations. That horrible mood swing would clear up by itself an hour later. That was how I knew it had to be the antibiotic. It was terrible. Like being thrown in a dark dungeon of despair. For no reason at all, out of the blue. That taught me that brain chemistry really matters, and a lot of things can influence brain chemistry, even sometimes things you wouldn't expect -- like an antibiotic.
6
As our understanding of the microflora in our gut and the job of microbes and our health increases, we have to be our own advocates in these situations.
6
After a long course of Cipro to treat a recurrent bladder infection, I experienced a spontaneous tear in the achilles tendon. Then several years later, a partial tear in the same ankle. In general, my ankle tendons feel weak and swell easily after long walks. I haven't taken an antibiotic in several years and with luck, hope to avoid them in the future.
5
As I write this I'm reading from my container, "10/26/2010 Take one tablet by mouth daily"
My G.P. saw me right away, and the X-ray showed I had low grade pneumonia. After apologizing that it was expensive, he prescribed LEVAQUIN 500MG, which I immediately filled. The pharmacist did tell me I should take it with plenty of water. That's all! Absolutely nothing about the other side-effects.
Shortly after taking it, I had a strange feeling I had never experienced before, that wasn't good. The next morning, I called the doctor and he saw me right away. I remember my words, "Unless you tell me I will die, I don't want to take another pill" Without any objections he did prescribe a different antibiotic which lowered my temperature, and I was fine.
A few weeks later at our dog park, I learned that a neighbor's husband, whom I just known as a nice guy, had committed suicide --- and learned that he had taken the exact same meds !
When I called Johnson and Johnson to see if I could get a refund, I sensed a certain relief from the other end. "No, you don't have to return them, just throw them away, and we will send you a full refund." I still hadn't known that these could be fatal.
I followed up by questioning other pharmacists about warning customers of the dire consequences. Every one said they would not do it, as the doctor is the one to give such a warning. In CA such discussions are mandatory, but not that they focus on actual lethal side effects.
16
Thank you, New York Times, for covering the issue of fluoroquinolone damage.
Ciprofloxacin was casually and needlessly prescribed to me a little over three years ago by a urologist, just “to cover any underlying prostatitis”. Chronic Prostatitis/CPPS is non-bacterial in 95 per cent of cases.
As of February 2019, The UK National Institute for Health and Care Excellence have updated their Clinical Knowledge Summaries, so that fluoroquinolones are now longer to be prescribed for Chronic Prostatitis/CPPS. This change is as a result of the European Medicines Agency review and public hearing that took place in London on June 13th 2018.
I had to be pushed in a wheelchair by my mother to visit my dying father in hospital, because Cipro had left me unable to walk properly, over six months later, among myriad other manifest damage/symptomatology such as;
CNS/ANS symptoms, dreadful insomnia, breathing difficulties, aches, muscle weakness, tendon damage, difficulty walking, nerve pain, skin damage, vision damage, muscle fasticulations, and involuntary spasms.
Fluoroquinolones can adversely affect people of any age, including young, previously healthy and athletic people. People have been and are, being given this drug when their lives are not even remotely at risk, without informed consent. That seems to be a relevant point here.
I hope people can understand that to have been so needlessly damaged is very difficult to rationalise and cope with on a daily basis.
10
@Thornton Wilder
"now longer" in the above comment should read "no longer". Apologies for the typo.
A few years ago I was prescribed a fluoroquinolone antibiotic for bronchitis (Levaquin), a ten day regime. On the second day I experienced tremendous pain in my calves and thighs and my leg muscles became so rigid I could not walk. I was in my mid sixties. Naturally my doctor changed the medication. Since then I have learned more about these drugs and their frequency of use. For example, I have had to have biopsies of my prostate (really not fun). The preventative antibiotic of choice is Cipro. The medical kit for foreign aid workers traveling to developing countries for use in case of infection typically includes Cipro as a broad spectrum antibiotic.
2
My understanding is that there is a black box warning on Cipro and that it a drug of last resort! Why do doctors know this and still prescribe it casually for a suspected UTI?
Both my husband and I have listed Fluoroquinolones on our medical charts as medications that we are allergic to. It seems to be the only way to be assured that they won’t be prescribed. My husband, on his second day of Levaquin, had a scary weakness in his Achilles tendon, so he discontinued it immediately. I have neuropathy in my hands and feet, probably from the many rounds of Cipro I was given for diverticular disease.
Doctors don’t like it when patients turn to “Doctor Google,” but we have to educate ourselves about all these many drug options. Knowledge is power.
16
I tell all doctors, all medical facilities that I am allergic to quinolone antibiotics. I've had soft tissue problems in my feet and achilles tendon for years, and believe it's due to having taken them in the past. I would never knowingly take that class of antibiotic.
8
I was given Cipro for years as I was prone to UTI's. I tore my rotator cuff as a result- really awful op, and long rehab. I am still wary of this class of antibiotic- and docs still prescribe them without asking any questions. I try not to take any antibiotics, but a year ago I needed one- after telling him I can't tolerate Cipro, he gave me something else and I looked it up on the internet- it was a Fluroquinalone.
7
I can testify to the dangers of Cipro. Twelve years ago I had violent pain on the left side of my lower abdomen. It was diagnosed with a diverticula infection. Not surprising since my father had this disease. Both Cipro and Flagyl were prescribed since it is very difficult to treat an infection in the intestine. A few years later, and several more infections, followed by the same treatment, I developed peripheral neuropathy. Thinking this was a consequence of aging feet, (I walk a lot as well as do the treadmill), my doctor looked up the side effects of these drugs. For the past six years I have been infection free because I simply cut out all processed grains. I have always been a healthy eater and love to cook. My cooking includes a lot of specialty lentils and different varieties of beautiful beans, fruits and vegetables, as well as meat, fish, and poultry as condiments on the plate. The only pasta I eat is whole grain from good sources, and if I eat a pizza, it is only a bite or two. This is not hard to do but you do need to love to cook to make it really tasty. The neuropathy remains in my feet but it has not spread any further. Just have to be conscious of shoes and their support and no more high heels. I would love to do workshops for people on how to eat with this disease — and make it better than anything a restaurant can make.
7
Big pharma needs to invest some time and money in discovering new antibiotic treatments instead of focusing its rapacious attention on tweaking expensive me-too drugs.
4
@Pala Chinta....The problem is that if a drug company were to develop and introduce a new antibiotic it would immediately be assigned by the medical community (correctly) to be used only in reserve, in order to prevent, or at least slow down, the development of drug resistance. This would guarantee that the drug would be a big money loser. As you would not put your money in a bank savings account that was guaranteed to decrease by 10% every year, you should not expect that a corporation would chose to do something like that.
3
I won’t deal with the big-pharma/hospital/insurance industrial complex anymore. It’s a racket. It pushes drugs and batteries of questionable, often worthless tests simply to generate income.
Costs are unconscionably high because the medical-industrial complex is a monopsony whose first priority is to extract as much wealth as possible from its medically ignorant and often captive customer base. It’s an extractive industry like gold mining, the gold Americans’ lifetime savings. The quality of patient care isn’t even an afterthought.
6
The prescribing of antibiotics by physicians is one of the worst areas of medical practice. The teaching of this area is poor and then persists throughout medical education. Most schools of medicine have lectures on antibiotics in their Medical Pharmacology course, but have no one who has an interest in the field. The result is that the students get one lecture each lecture on bactericidal drugs, bacteriostatic drugs, misc. and TB drugs and then one on antivirals. After that, it's "God go with you and your patients." My medical pharmacology course has 11 hours for that material and the instructor has it reviewed by a physician from Infectious Disease in the hospital.
Every July when the newly minted docs show up from other institutions to start their residency training, my Infectious Disease guys moan and groan over the lack of understanding by the new physicians.
And they have pushed and pushed the last four years to reduce the use of Cipro as they believe it is responsible for the rise in clostridium difficile infections that produce a miserable diarrhea in the patients. That effect is due to killing the useful bacteria in the gut that keep C. diff out.
When I asked my colleague in ID what his job mostly entailed, he replied, "90% is reduce and eliminate (antibiotics)."
10
As a layman, I strongly suggest the simple sugar, D-Mannose. It is an evidence-based OTC medicine that can treat and prevent UTI's by preventing the bacteria from taking hold in the bladder.
Of course, take the necessary precautions by running it by your doc or pharmacist.
10
Doctors own this mess, not patients. Just say no to your patients if they ask for antibiotics and explain why - a teaching moment. While you’re at it, say no to the pharmaceuticals who are pushing the drugs. What ever happened to First, Do No Harm...oh yeah - money happened.
20
Not just money happened. Patient satisfaction surveys happened. A demanding patient who doesn’t get what they want complains...a lot, and to lots of people. Too many complaints and the doc is in trouble.
4
@nina nina My spouse is a physician. They almost always have a viral respiratory infection that will heal with symptomatic treatment and a little bit of patience.
2
@Buckeye Lady
So push back! Who’s in charge? Doctors need to stand firm and do their job, which is to protect their patients’ health. If they can’t even do that, then what’s the point? The institutions that harass their employees because of ethical and medically sound practices should be getting that grief, not the doctors.
2
My 98 year old mother has been demonstrating increasing anxiety and irritability for the past 10 years. She is one of the many elders that immediately call the doc and request antibiotics for any sore throat/cough/runny nose, and her doctor sends in a prescription. It drives me crazy, but I have been unable to convince her to stop this nonsense and let the cold/virus take it's course. I had believed her increasing mental distress was related to her elder addiction to FOX News, now I see that the antibiotics could be playing a role.
10
I have always been careful about antibiotics and my primary care doctor was an early adopter of not handing out antibiotics. In 2016, I had major shoulder reconstruction surgery, to correct a failed surgery for a shoulder fracture. Since it appeared that I might have a shoulder infection, a PICC line was inserted at the hospital and I had the antibiotic Vancomycin infused twice a day at home. I developed a delayed adverse idiosyncratic hypersensitivity reaction, called DRESS syndrome to this medication and had to be hospitalized. DRESS comes with a fairly high mortality rate. I was lucky, although I suffered greatly. I am extremely cautious about antibiotics now. Like many medications, antibiotics can have major, severe, and life threatening complications.
10
Doubled over with a UTI I was given Cipro. It did nothing. No cure, no side effects. Older antibiotic cured it asap. More likely older patients are given the impression that UTIs are "normal".
Let me add UTIs in the elderly should be taken seriously. My mother's UTIs led to a kidney infection and decline.
12
Decrease pain should be the goal. I spent a week on vacation sick because local doc wouldn't give antibiotic. Went home, saw my doc, got antibiotics, got better. On short the thrust of this story is hooey.
3
How do you know that you wouldn’t have gotten better even without the antibiotic?
11
@Rhporter Same question. How do you know this? You may have been on the tail end of your illness, anyway, this fits.
5
No. Hooey is believing an anecdotal example (even if it's your own) and denying the weight of evidence gained through scientific inquiry.
8
I was a very healthy and active 25 year old when I took Cipro for just 3 days. After 3 days every tendon in my body lit up in pain, which has barely subsided after 2 years, and appears to present a constant and perhaps permanent threat of rupture. I was another person who read the label and thought “well they have to put those warnings down, they never really happen”.
Please - doctors and patients alike - read the comments in this thread and take heed. Cipro and other fluoroquinalones are not fit or safe for human consumption.
16
Yes, they do happen and I’m one of the victims as well. I ache constantly and am hoping it subsides. Sorry for your pain!
8
@Mary A
Another cipro victim here. I was given it for a UTI and within 4 days my shoulder tendon was on fire. I looked up cipro online and saw that it should not be given for anyone elderly (I was about 70 then), or for anyone who had recently had a CT scan (check: just had one). It took months of physical therapy to get my shoulder comfortable again.
11
I'm thinking of my poor old Father, who died at 93, and was lucky to have had a wonderful, and pretty healthy 90 years. His only major hospitalization had been a week following a Motor Scooter accident at 88. Exciting as that sounds he simply fell over at a stop, discovering he was no longer able to really support the weight of his scooter.
In the last 30 months of his life he had one urinary tract infection after another. He'd finish one regimen of antibiotics, have a month or two of good health, and then start another round. The Doctor even suggested that Dad be circumcised - at age 92! (Dad didn't agree to that.) His last round of Cipro was at 92 1/2. He said to me: "Let me die of this infection. I'm going to die of something, why not die of this?" I wish I had listened to him - but I was kind of afraid of being charged with murder. The next six months were awful to witness, and yet a classic example of how people die today: Intensive care, rehab, nursing home, intensive care, rehab, nursing home. I don't blame the Cipro, he was very very old and failing. But we do die of something eventually.
31
Everything is in flux right now.
Antibiotics, baby aspirin, statins, even blood testing for diabetes 2.
The only thing we know for sure is that drug companies want you to keep taking this stuff.
35
I am in my 30s and had a doctor lazily prescribe Cipro for a simple UTI. When I saw the much-longer-than-usual list of warnings for the drug, I started doing some research. Online support group after online support group for people who had been debilitated by this drug in some way. And the FDA's black box warning confirms many of the potential issues. I'll keep my tendons intact, thanks.
You can argue that the only people who go online to talk about their experience with a drug are those that are extremely dissatisfied, or the rare few that think the drug was great. But no other antibiotic I researched had the number and severity of complaints of Cipro/fluoroquinolones. It should be reserved for infections where there is no other viable alternative antibiotic.
19
I took Levaquin for bacterial pneumonia. Necessary, but brutal.
3
One of the issues is that there is little to no accountability for the overprescribing of antibiotics by any individual practitioner. Antibiotic-use guidelines are frequently ignored without consequence.
There is a case to be made for making antibiotics controlled substances or otherwise tracking their use by practitioners. It may turn out that much of the antibiotic overuse comes from small sections of the medical community where appropriate intervention can be taken. An individual who is way outside the norm is likely to self-regulate if informed of community statistics. Right now, most practitioners have no idea where they stand. Just knowing someone is watching is likely to change prescribing patterns.
5
How to lower the cost of healthcare ?....less unnecessary treatment.
Fewer doctor and ER visits for ...colds, flu and hangovers.
Few Rx that wont do anything useful.
Better health causes lower healthcare costs.
Pay for health, not diagnosis of 'whatever might ail you'.
Healthcare insurance is a racket as is the entire healthcare industry.
Industrial healthcare does not work for the consumer!
8
People! Fluoroquinalones are lifesaving! Have any of you had a bad urinary tract infection? Like needing to pee broken glass every minute, fever, and not even being able to get off the toilet to see the doctor without being incontinent in transit? Every time you have sex? Even in Europe, where the medical system is extremely cautious with antibiotics, and after encouraging pelvic floor therapy, use of cranberry/bearberry extract, and every possible other sensible alternative, in common with Canadian practice the urologist prescribes one Cipro immediately after sex. This has changed my life--and saved my marriage. One pill! I do not feel physically ill after taking this--and I have even resumed back-packing / gone long-distance cycling / gone downhill skiing thereafter, and felt fine. From my point of view, over the last thirty years these antibiotics are, and have remained, a miracle for me. (And yes, I've used others, but Cipro seems to suit me fine.) We are so incredibly lucky to have this stuff! It seems to me decadent to live in a culture where we are able to cure such suffering, and then spend our time moaning, worrying and objecting. Try living without it when you need it!
19
If you take an antibiotic before or after sex then you must do so wisely. I take one Macrobid and drink lots of water with Uva Ursi (drops or tea). After reading this I’ll not take this type of antibiotic unless a lab analysis indicates it is the best and only option.
9
@L. Rand
I don't think too many people are disputing that fluoroquinolones have an important place in the antibiotic arsenal. What people are saying is that they're often overprescribed, that they're "big gun" antibiotics that should be reserved for infections that don't respond to other, less potentially damaging antibiotics, and that for those who are susceptible to the adverse effects of this class of antibiotics their use can be life-altering in a very bad way. Your are among the fortunate group that is able to use these antibiotics without ill effect. Others are not so fortunate, and because there's no good way to know, right now, who will respond badly to these drugs, they should not be routinely prescribed when workable alternatives are available.
23
@L. Rand It is not stated, or advised, that they do not have a place in treatment. The point is, they are WAY overprescribed. the bugs develop resistance to them.And that is the very reason why they might not work when really needed, like for c.diff. Yes, you had a good recovery. But you might have had the same recovery with Gantrisin, which has been around for over 70 years, Or a lesser antibiotic. Cipro is a great drug. Hope it stays that way, rather than being ineffective for poor prescribing by docs.
5
After every major dental surgery Amoxicillin is prescribed to me. And before every dental procedure the dentists ask that I take four of them. Is this really necessary or is this just one big CYA on the part of my dentist? Let’s get some new information on this please.
9
@ClaudiaBee
There is more information out. Maybe your doctor doesn't have it or needs to be made aware of it. Based on newer studies, my knee surgeon no longer recommends patients take antibiotics before going to the dentist.
3
@ClaudiaBee
Having almost 40 years with the same dentist, I have never been Rx any antibiotic even when procedures are invasive. I am aware this is precautionary for patients who have a history of heart disease, which I do not.
Conversely, ignoring dental problems, particularly deep infection calling for root canals, can result in heart disease.
A friend, who had excellent dental insurance through his quasi-government employer, put off treatment of molar pain for years because he did not want to fork over the 50% co-payment (standard to dental insurance for at least 50 years) to crown the tooth following a root canal. He was laid off, COBRA ended and he landed in the hospital three times last year due to infection caused cardiac disease, with one stay lasting almost two weeks. The amount he spent on Excedrin and Motrin while he had a job would have covered the co-payment.
2
What is the third leading cause of death in the US.
Yes, that's right ....healthcare. This article points out how dangerous medical treatments are to the patient; often with no tangible benefit in sight!
19
Another result of our de facto criminal health care system, in this case legal drug pushing by big pharmaceutical and HMOs.
Some people who have good health insurance go to doctors every other day for pill relief for every ache or pain for everything while people who need a pill every now and then don't get it because they can't afford it.
The end result of a de facto criminal health care system.
15
Thank you so much for your article. We have been trying to determine the source of my mom’s confusion and back pain for the past two weeks. After multiple trips to the doctor no leads until last night we collectively began to speculate about a UTI or a kidney stone. Cue your article this morning. As we head into her doctor’s office today we will be armed with important information about which antibiotics to request if her tests come back positive. Thank you for the (in our case) very timely article.
13
All Antibiotics have negative side-effects that PCP's never disclose to their patients. If I had any clue that Levoquin, prescribed for a bout of pneumonia awhile ago, would turn me into a sleepless zombie for an entire week, I wouldn't have taken it. I've since learned that tendon rupture, tendinitis and other side effects have been associated with all of these fluoroquinolone class antibiotics, though Levaquin has drawn the most lawsuits to date.
16
I’m right there with you.
3
Amazing. This article was posted March 15. I had total knee replacement of one knee on March 13. In the last two years or so I have had a series of apparent UTIs, and discovered I again tested positive for a UTI on March 12, day before the surgery. Hurry up, 750 mg of Levaquan day before surgery, 750 mg day of, 750 day after. Whew! So when I was in the hospital (don't remember if it was the 14th or 15th), my doctor says he doesn't think I have a UTI after all, he thinks I have asymptomatic bacteriuria. How is that for timing? Don't know if he saw your article or an article in a medical journal. Fortunately, I seem to be OK. Also, my husband has a doctorate in pharmaceutical science, so he tends to keep up with stuff. Thanks for the article.
16
Why isn't the prescribing MD required to explain this and get you to sign a release/informational waiver. They make you sign numerous HIPAA forms, why not something useful. of course I might just outlaw these drugs except for extreme circumstances.
7
The fluoroquinolone antibiotics (Cipro, Levaquin, Avelox, their generics, etc.) deserve special attention, for their wide range of adverse side-effects, some delayed by days or even years, and some persisting for years, thereby disabling people.
In 2015, the FDA named FQAD, or Fluoroquinolone-Associated Disability, for the FQ abx cluster of delayed-presentation or persistent adverse side-effects. But physician awareness of FQAD isn't broad yet.
FQ adverse effects include mitochondrial DNA damage, faulty collagen expression, and CNS effects to both body and mind, beyond those you've described.
Do most doctors know all FQ abx symptoms? Do they know about delay and persistence? Or the ICD-10 codes that could be used for FQAD-related diagnoses? That athletic teens are as at much at risk for effects as seniors are? That *anyone* can suffer effects, no matter age or base health?
Without physicians' awareness, there are no funds for diagnostic methods and treatment protocols, and FQAD cases are under-recognized.
Has FQ abx over-prescribing and FQAD unawareness contributed to growing fibromyalgia diagnoses, or chronic pain cases treated with opioids? Are there traces of FQ abx's in the commercial food supply? Are there FQ abx traces in fast foods, which disturb gut microbiomes and contribute to obesity? Are FQ abx's used in the equine racing industry? (They are for dogs and cats.)
I will comment again, about my own FQ abx experience.
15
@heath quinne
Thank you for this information. I had heard there was a cover-up regarding dangerous mental side-effects of this class of antibiotics.
Many times doctors are last to know...or last to believe.
2
This has actually now become the opposite problem. I thank god that my doctor is savvy enough to prescribe antibiotics when I need them; he is not one of what is becoming a new breed of "antibiotic withholders." It's like an obsession with them. I have friends who have resorted to going to Algodones, Mexico, to get needed antiobiotics because their doctors refused to prescribe them when truly needed. It may be socially correct for doctors to refuse to Rx antibiotics for their patients, but I am thankful that mine is not one of them.
6
@actualintent How would you know? Antibiotics are the most over prescribed treatment and have lead to serious problems....and less effective results. Give it up...you know not of what you comment on.
16
Nothing about dental work here. I’m 65 and the only antibiotics I’ve had in years is for dental implants and associated jaw bone reconstitution. After 4 implants I’m wondering...
5
I took one Cipro a couple of years ago for what the MD assumed was a UTI. Within hours, I felt odd, detached and anxious. When I went to bed my body was shaking all over and I thought I was going to die. At the ER they could not even place the patches for an EKG on me because I was shaking like crazy. Luckily, everything subsided the same night and there was no lasting damage. After reading this article I feel blessed. This experience was so scary compared to the hives penicillin gave me once. I will take note and try to be vigilant the next time.
6
@Karen B. I would never take Cipro. But I am not afraid of antibiotics in general and I think this article is alarmist.
7
Please take heed of these warnings, what you see here is the tip of the iceberg. You can find yourself with long term and possibly permanent damage from just one or two pills of this dangerous antibiotic. Your doctor will have no recourse. We are thankful for this article and everyone who told of their tragic experience.
12
An additional concern not mentioned in the column is that Ms Isaacs did not actually have an infection requiring antibiotics. She had asymptomatic bacteriuria, or bacterial colonization of the urinary tract. There is high quality evidence that this condition does not benefit from antibiotics in older patients. The cipro prescription was not indicated to begin with.
22
When 52 I had a critical reaction to one capsule of Levaquin, a fluoroquinolone-class antibiotic prescribed for a mold-related pneumonia. After a doctor stopped that FQ abx, I didn't think about it again. That was twenty years ago. As is common for people affected by FQAD (Fluoroquinolone-Related Disability), had no idea that I was. I lived with many strange symptoms post-FQ exposure, which I, and doctors, connected to other things in my health and life.
It was only in 2017, after years of increasing disablility and pain, with no diagnoses or treatments helping, and a relative dying young of symptoms similar to mine, that I discovered what FQAD was, and that I might have it. It took a year of lifestyle, nutrition and movement method changes (gleaned from other FQAD people via a FB support group), to ease symptoms, get free of pain, and improve mobility.
In 2018, a critical episode of rhabdomyolysis (which FQAD likely increased my susceptibility to) disabled me again, and I am rehabbing again.
Please help get the message out that FQ abx's can produce delayed and persistent effects that can be disabling and painful for months or even years. And, potentially, for a lifetime.
Unless FQAD awareness rises, and funds are allocated to research FQ abx effects' underlying causes, diagnosis methods, and treatment possibilities, many many people will be disabled by FQAD, with the number only growing, as long as FQAD ignorance is standard - as it now is.
Thanks for your article.
18
My elderly wife suffers from Parkinson's disease where neurologists always say if a PD patient may even have the slightest chance of an UTI (affecting falling or dementia issues ) to go to a First Med or ER and have urine tests made both instant and and standard 2 day UTI test cultures.
She was given a Sulfur based drug for one "iffy,may or may not be UTI" diagnosis.
The Sulfur made her crazy ,nervous and crying ,who knew that?
Stopping that antibiotic helped her with good ol fashioned Septra
to remedy her mild"iffy"UTI.
And yes ,people such as my wife who are wheelchair bound and use nappies 24/7 for incontinence sit in urine even from a dribble on the pads often making caregivers think it is a UTI when any issue arises that affect the elderly that we we know from the medical literature or "Dr Google" may happen.
As a result 80% of my ER or First Med visitations with my wife there was no UTI present but the medical Drs.always want that possibility tested first.
One young Dr at a fast med hospital based type of place was not satisfied that she had no UTI ,sacred us to death it might be a life threatening illness ,scared me if we did not go by ambulance just 3 blocks away for additional tests she could die ,said he would state I have an against medical advice (AMA) listing if i did not listen to him ,we reluctently complied.
After 9 hours in the ER where she had every blood test and regents work available to human kind ,guess what, zero infections?
7
I too had a horrible reaction to sulfa-based antibiotic. I thought I would die...
2
Was prescribed Cipro for a UTI. After only 2 pills, needed to go to the ER for tingling in the arms and toes. Stopped taking it and found out I didn't even have a UTI!!! Anyway, fatigue, lightheadedness, aches and pain in joints lasted for 3 months. Needed to see urologists, neurologists and rheumatologists. DON"T TAKE CIPRO!!! Check out the I have been FLoxed website and you will never take this drug again.
13
I like many others have had their health ruined by Fluoroquinolone Antibiotics.
The addition of fluorine helped The Antimicrobial agents penetrate deep into the cells and reached infections that were hard to get to. But in penetrating so deep they also wreck havoc at a cellular level and cause permanent damage. Mitrochondria (which are evolved bacteria) are compromised and the gut bacteria destroyed. Collagen is depleted.
This causes multi systemic problems both physically and mentally. May suffers report anxiety and cognitive problems.
The symptoms are identical to so called Gulf War Syndrome. All soldiers who were sent to the Gulf were given fluoroquinolone antibiotics for months.
25
Be aware of these insidious drugs. They cause delayed adverse reactions. They don’t always cause immediate reactions, like while on the drugs! Be aware that the Fluoroquinolones are given without your knowledge or permission.
12 years ago I was given IV Levaquin as a prophylactic during minor surgery. I HAD NO INFECTION! Within a few months my body started to fall apart and I have not recovered.
For me damage was permanent!
10
@Sharon
Jean from Michigan
I had bladder infections starting relatively early in young adulthood. It kept getting worse until several years ago I would have an infection every few weeks or months. I was found to have practically no antibiotic that was working any longer. I sometimes had to urinate every 15 minutes. I was spending more than a hundred dollars on bladder pads. I went to a urologist who basically never treated me but put me through three intrusive tests including a biopsy. Thousands of dollars later to the insurance company and me the only tx irecieved was prophylactic Cipro even though I had told them I
was no longer sensitive. I control my infections now with health food products and essential oils.
I have read many natural health materials and combined products that kill germs, fungi and virises. I take these natural products daily. I am 76, lucid and alert and function independently.
3
I became very ill after taking Cipro when I was 40. At 50, I had a respiratory infection and I told the doc I was allergic or had a bad reaction to Cipro and he gave me Avelox. Avelox is in the same Fluroquinolone family. I became disabled from 6 pills AT age 50!
13
@Deniese
I am in the higher-risk group for adverse effects from fluoroquinolones as I am 60 with arthritis. I actually wear a medical ID bracelet (a really cute one!!!) stating that I cannot take this class of drugs. Here's hoping that if I'm ever in an emergency situation they actually look at the bracelet.
15
One round of levaquin three years ago for the very first UTI I ever had has caused such widespread damage in my body It’s been a nightmare. I was a perfectly super healthy woman who is now still trying to regain her health. Chronic tendinitis, plantar fasciitis, torn labrum, hernias, teeth issues. All following one round of levaquin. There was not one issue in my health chart until the week after I took this evil drug. I am leery of pharmaceuticals and Drs now and my quality of life has been greatly diminished. Since this nightmare I have networked tirelessly to get to the bottom of my issues. It wasn’t until I met someone who had been leveled by Cipro that solved my unexplained decline in health. He was a 40 year old elite bike racer. I am not healed yet. I am fighting everyday to get my life back.
38
It took me a few years to feel normal after a 2 rounds of cipro for “uti” and “possible kidney infection”- though I still have wonky ankles and episodes of foot pain. Ironically, found out later these antibiotics are very rough on the kidneys.
10
It’s not my dentist who wants me to take Clindamycin before appointments. It’s the surgeon who did my two knee replacements. I have a dentist appointment coming up and I’m not going to take the antibiotic. Heaven help me though if a knee gets infected!
Since there are so many knee replacements done every year, more information on this in the NYT would be helpful.
13
I have no idea if this has any scientific merit but I swish with diluted peroxide before dental cleanings to reduce the bacteria in my mouth that might be stirred up.
5
@Kathleen
The ADA position is linked below
https://www.ada.org/en/member-center/oral-health-topics/antibiotic-prophylaxis
There have been several studies debunking the need for routine antibiotic prophylaxis before dental work. They can be found easily with an internet search.
2
I took Cipro long before the first black box warning was issued. I finally connected the dots on my second round years later as I had body-wide tendonosis that lasted for years. I was youngish on my first round as well. I'll never take another fluoroquinolone. I can't imagine how much worse the damage would be if even one more dose was ingested.
12
I was given a generic version of Levaquin several years ago for an infected mosquito bite. Within an hour of taking the first capsule, my knees became numb. The material that came with the pills didn't have a black box warning and the pharmacist didn't mention any side effects, but the web turned up a lot of serious permanent side effects, including neuropathy. I stopped the Levaquin after that one capsule but have not yet recovered feeling in my knees.
There are large class action suits against the makers of the fluoroquinolones but generic drug makers are immune from suits. For this we can thank our lawmakers. And being immune from lawsuits, they don't bother with black box warnings.
As the article mentions, despite all the FDA warnings issued to doctors, doctors still prescribe fluoroquinolones routinely for minor infections.
36
@TechMaven
Peripheral neuropathy due to Levaquin almost exclusively begins with numbness and tingling in the feet, not in the knees, and It would be almost impossible for this to occur in less than an hour after ingesting the medication. Your case would be worth publishing in a medical journal if it were verified by a nerve conduction/ electromyography study and neurology consultation.
4
@Henry
EMG/NCV tests can detect problems with larger myelinated sensory and motor fibers. However, EMG/NCV tests are usually normal with small fiber neuropathies. In May 2000, out of nowhere, I developed burning pain on the bottom of both feet. Multiple diagnostics, including EMG/NCV tests, were performed over the subsequent years with no answers as various symptoms manifested. It wasn't until 16 years later (when the correct test was performed -- skin punch biopsy) that I finally got the diagnostic answer: small fiber polyneuropathy. Two years of tests to determine the cause came up empty. The smoking gun? When the burning pain on both plantar surfaces first appeared, I was in the middle of a 10-day course of Levaquin. It wiped out my sinus/respiratory problems. Unfortunately, the collateral damage I will be paying a lifetime for.
1
I was prescribed Levaquin ( a fluoroquinolone) as a "prophylactic measure" during an asthma exacerbation. I had no bacterial infection. 2 pills resulted in permanent disability due to damage of several organ groups- peripheral neuropathy, tremors, sleep disorder, chronic tendon damage and continual tears even 7 years later, multiple myopathies. Recently, I had a nasty gash to my arm which required a trip to the ER for stitches. The ER doc wanted me to take a full 10 day course of antibiotics to "prevent infection". I said I was not interested in taking an antibiotic when there was no infection, and I asked if the doc was aware that there has been a change in protocol for the use of antibiotics prior, during or after major surgeries ( 1 does 1 hour prior to surgery, and perhaps a second dose if the surgery lasts for more than 4 hours- but no further antibiotics after 24 hours). Stitches are not a major surgery. A course of 10 days of antibiotics was simply not appropriate. She insisted I should take them and forced a prescription i nto my hand. I didn't fill it- I simply followed sensible wound care, and 10 days later, with no oral antibiotics, there is no infection. As the article points o ut, the biggest problem is doctors who continue to prescribe the drugs inappropriately.
23
Good article. I wish I had known about fluoroquinolones before I was given Levaquin by a doctor for a sinus infection six years ago. I'm now left with permanent damage to my achilles tendons of both feet and the tendons of both elbows.
Stay away from Levaquin unless it's your only recourse.
19
A 68-year-old who is feeling well gets talked into taking a powerful drug like Cipro ? No surprise that according to the CDC, 91% of Americans age 65 and over are on a prescription drug.
13
Happens to younger women too: happened to me when I was in my 30s.
8
From the article:
"Caryn Isaacs didn’t do well on Cipro. She suffered severe chest pain — “I thought I was having a heart attack” — and felt anxious and irritable.
"She finished the weeklong course of the drug anyway and her personality changes have receded, she said. But occasional twinges of chest pain persist, along with a sense of weakness."
I hope she gets that chest pain checked out.
4
Some drugs can cause unusual arrythmias- mentioned in the very fine print which pharmacy usually doesnt give you, but which you can find online.
3
@Laume
All medications picked up from a pharmacy have a drug insert included.
2
@Steel - If people bothered to read that illegible, tiny insert, they'd never take the drug.
8
Old people are like children, they do, take and go where the doctors tell them without questions or thought.
Bad policy.
9
@There
I think you mean to say "some" older people.
And just for the record people of all ages, not just the elderly and children, tend to get sheepish when dealing with doctors. Blind adherence is just as likely in a 30 year old as a 70 year old.
29
@There This 74 YO woman doesn't, nor has she ever subscribed to your unjustified comment. All my western-medicine doctors, over decades, were/are keenly aware of my beliefs as to what I allow into my body. I take NO pharma toxic drugs, prefer alternative options, eat clean, sustainably-raised, organic food, exercise regularly, hydrate with alkaline water, keep a positive mind. Our health (good or bad) is a choice.
10
@There
"Old people?" Excuse me? Older adults are as individual in their behavior as any other group and most of the older adults I know, myself included, do not hesitate to ask questions and, when appropriate, do their own research when their questions are not adequately answered. Check your stereotypes.
14
Avoid at all costs. In 2017, I had an infected finger that needed surgery. Post surgery I was given Levaquin, three days later the tendons in my calf were ruptured. I was in a boot for 3 months and have felt nerve pain in my calf ever since. I can only speculate the destruction it caused my microbiome...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921747/
14
Unfortunately no one ever thinks to culture for fungal and test for viral infections. Most often no testing is done because no curiosity exits, no thinking is why Azithromycin is the most popular antibiotic. Unfortunately the microbiology world has ways to adapt and survive causing more illness in spite of antibiotics. What is the most common cause of death, pneumonia an infectious disease.
6
@Michael Morris MD In France, no matter how miserable you are, docs will not give you an antibiotic until all the tests come back from the lab marked by each drug "sensible" or blank if it is not. then your physician chooses from the least powerful drug. They will, however, give you pain killers while you wait for the results.
4
Thank you for this urgent and necessary reporting. it's really a shame that in the fee for service U.S. healthcare system, more each year the surest way to stay safe and well is to steer clear of the system entirely-- or at the very least, learn how to say no, no, no!
Two items I believe were missed, possibly because of length considerations: effects on microbiome/microflora and thus consequent immune, nutrient, overall GI, and even mental health; as well as the potentially devastating consequences of fluoroquinolone toxicity.
I have several patients/clients whose lives have been absolutely ruined by even a short (but unnecessary) course of these drugs. (One, a 40 year old, Harvard educated nonprofit attorney.) The FDA has since issued stronger warnings against their use, but an argument could be made for removing them from the market entirely. Internet search for "Floxies," as their self support group has come to call themselves, will yield more information for those interested.
22
Docs need prescribing nomograms for empiric antibiotic selection approved by . There is no gorilla cillin that kills everything. They loved Levaquin for years because it was easy, no thinking required. Initially many docs have to guess the source of the infection, then guess which abx would be wise. And by the way, you do not want to be stricken with a c diff over growth in your guts. Its horrible and sometimes kills you in a horrible way.
5
Took Levaquin several years ago for sinus infection confirmed by x-ray. Not knowing the risks and being an avid cyclist, did a fairly hard ride and coming in house severe calf cramps that put me on the ground. Sore for days after. Alerted doctor about precautions.
3
@Justifier
I'm almost jealous of all these people whose doctors insist on prescribing antibiotics.
I get a Bacterial sinus infection two or three times every year. It meets all the criteria: temperature, lasts for weeks, etc.
Last year, I had one in December. After waiting three weeks, I got Zitrthomax from the doctor and was fine in two days, although I finished the prescription.
In April, a second one occurred. Even after a month, the same doctor said I will not give an antibiotic, although he idiotically prescribed treatment for asthma, which I've never had. After a month of misery, I saw another doctor, who looked at my nose, and said, That is one of the worst stuffed-up noses I've ever seen. Two days of Zithromycin, and I was fine.
I told the first doctor, whom I need to see for geographic reasons, that if he ever denies me an antibiotic again for what is obviously a bacterial infection, I'm getting another doctor. Sometimes, a bacterial infection is just what it seems.
The moral: Know your body. And your doctor.
BTW, I have taken Cipro a few times. I guess I'm one of the lucky ones whose body was not destroyed.
3
"Tendonitis" not "Tendinitis." Curious to know the scientific background of this author as well as the editor.
5
@mkaz Oops, we will correct the typo. Thanks for pointing it out.
1
@mkaz, In the very recent past the NYT disbanded theiir copy editing desk and I suspect reporters and editors are still getting accustomed to having to copy edit their own work.
9
@mkaz Hmmm, turns out that "tendinitis" is Times style and the dictionary's preferred spelling.
17
took CIPRO for UTI....later resulted in torn meniscus in my knee...$#@!DR.!
7
The correct heading should have been:
"Older Americans Are Awash in Prescription Drugs."
6
Cipro triggered panic attacks in me when I was in my 40s. The doctor denied that was even possible when I reported it.
It is a nasty drug, and should be avoided.
However, I do not agree with not treating a UTI. I, too, have seen the mental confusion that can result from one and would not risk it.
8
And don't forget the increased risk of ruptured aneurysms with fluoroquinolones. Having said that, we primary care doctors are under immense, and constant pressure from patients to prescribe antibiotics because "this cough has lasted 4 days!", or "I KNOW I have a bladder infection." Yes, I spend time trying to educate patients, but we all frequently cave in and call in an inappropriate antibiotic. Don't judge me, I work 70 hour weeks. Patients get ANGRY. They will just get it elsewhere. Sometimes you just cut your losses and prescribe a short course of a low dose, relatively safe antibiotic. Now, about all the antibiotics dumped in animal feed every year...
137
@epistemology "Do no harm"
10
And it takes an additional 10 minutes to explain why you will not prescribe antibiotics. The retail store clinics encourage people to seek care for their garden variety colds. Its integral to the marketing for the retail clinics. The $80 plus charge causes the expectation that one will get a product to get rid of the cold. Its a racket that I did part time . I only sometimes caved in when the pt’s tears flowed, begging me for an antibiotic prescription. But I could only see 12-15 pts in 8 hours, because I spent so much time explaining “why you don’t need antibiotics.” In another store clinic at Walgreens, 40 pts were seen in 8 hours, most of the folks receiving azithromycin for their “sinusitis.” The pts at that retail clinic were so satisfied.
So if you have a cold, stay home, heat up the chicken soup, gargle with warm salt water, take tylenol and lie down. A tincture of time will cure you.
51
@epistemology
Dear Doctor - Do you think that years and years of being told in ads by BigPharma to "ask your doctor" to give you this or that prescription drug has caused the insistence that you give them an antibiotic? Is it possible that the American Medical Association could vote to lobby Congress to end the prescription drug advertising? Only the U.S. and New Zealand face this incessant (and, clearly dangerous) direct-to-consumer advertising.
59
Years ago I was prescribed Cipro for a UTI. It triggered a horrible series of panic attacks -- which I had never had before. I later found out that this is not an uncommon reaction to fluoroquinolones. Luckily they ceased when the medicine cleared from my system. Caveat emptor.
6
My mom was in her 90s and had vascular dementia, but would frequently get "loopier" than usual - hallucinations, voices, etc. - the first thought from one of the docs at her nursing home was to put her on an anti-psychotic. As her power of attorney, I refused and demanded a urinalysis because even before her dementia advanced, she would develop odd mental ticks when she had a urinary tract infection, but she would have no other symptoms. Silent UTIs are a problem in geriatric women and they do need treatment.
Generally, a quick round of Macrobid did the job. I can't understand why Cipro or Levaquin are the first lines of defense for some docs. They should be a last resort.
67
@knitter215
Thank you for confirming this issue. I went though the same circumstances with my mother. She too suffered from Silent UTI's I was able to quickly recognize it each time it happened and did what you did made sure she received treatment, through demanding that she be tested and treated.
5
@knitter215
I agree with your letter. I would add that my father got crazy with UTIs. Men can get them also.
5
@knitter215
Good for you for blocking the use of an anti-psychotic for your elderly mom. Nursing homes were sold it as a way to "calm down" (sedate) patients by Eli Lilly, in a campaign for Zyprexa called 5 at 5. Many patients died, and still are. The drug has a black box warning against giving it to the elderly, along with black box warnings for diabetes and hyperglycemia.
6
A patient advocate such as Ms. Isaacs who doesn't know enough to research a drug before she uses it should not be permitted to advocate for anyone -- not even an earwig.
Further, no one with at least the sense of that notional earwig should take any medication without checking its indications and contraindications, and then deciding whether the risks are worth it.
4
@Rea Tarr There are so many elderly patients that cannot begin to do the research needed, and they are often the most vulnerable to the consequences of bad prescribing, as this piece highlights. They may not be able to read and interpret the insert from their pharmacy, for example.
Many of the oldest old grew up in a culture in which questioning the doctor wasn't done. Their children may not be available or don't have any idea that the same drug they took without harm may not work well for an older person.
24
@Cathy
I'm in my 80's; so are most of my friends. We've always questioned everything. We're well-educated; we even are able to read and interpret package inserts of every type.
Please stop encouraging age discrimination!
67
Most of the prescribers, the “health professionals”, who should know better, are not elderly themselves. You are blaming and slandering victims- many of whom are far from elderly. And countless younger people insist on antibiotics for every slightest cold.
3
It’s not John’s big Pharma that’s behind the antibiotics. The trial lawyers Association is a major component. I recently had a patient who developed an infection presumably from a urinary tract infection. I was sued because I didn’t screen the patient during her routine Office visit. The trial lawyer said that that could have prevented the infection if she had been screened.
12
I had the "winter cold" and asthma that many of my older friends and younger grandchildren were coughing and sneezing with. The doctor, not my trusted regular doctor, said "possible subtle pneumonia or asthma on x-ray and prescribed levaquin (a fluoroquinolone). I'd no history of trouble taking any antibiotic. Four days later I could hardly move my shoulders and arms. Now, eight weeks later the pain is down to about 15% of the earlier. I can sleep well again. I can turn in bed. I still am watchful for ruptured tendons. Sadly I suspect I never had pneumonia, subtle or otherwise. I understand that a 76-year-old is at a greater risk for hospitalization, but ...
19
I have been present when the patient will ask for certain medications by name. The physician will provide meds as requested in some cases. They should learn to say NO, but are afraid to lose the patient and the Medicare reimbursement fee.
Once in while "to do no harm " should be remembered.
28
@John Ramos
In my area docs are not afraid to lose patients over an issue like this. They are so swamped with patients they do not have time to explain.
3
Excellent article .
In America there is definitely overprescribing of drugs for any kind of situation , like in this case of asymptomatic bacteriuria.
Big Pharma must be the engine behind this erratic prescription behavior.
One needs to be informed before starting a treatment, too often doctors don’t have time to explain and one ends up with an expensive medicine that might cause more harm then good .
Be vigilant , ask questions to nurses or pharmacists , if communication with your doctor is limited .
Better safe than sorry.
10
@inter nos. If communication with your doctor is so limited the s/he cannot or will not explain why they are prescribing a certain drug and its potential benefits and drawbacks, find another physician. Don't ask the office nurse. S/he has no special training or expertise in this area. Also, don't wait until after the drug has been prescribed to ask about it.
9
They advertise direct to consumers! Advertising works, thats why its such a huge industry. Pills are big business, and that includes generic drugs and supplements, too.
I was prescribed Cipro for an abdominal infection following a colonoscopy at Kaiser. I got progressively weaker and developed pain in my Achilles tendon. On day 8 of 10 I called the advice nurse who told me to stop taking it and get to the ER. This was 4 years ago and the tendon is finally calming down, only a little weakness there but no more pain.
If you have a reaction to fluoroquinolones you should carry a medic alert in your wallet or a bracelet.
29
@sally
In a different situation, but regarding the effects of Levaquin, my partner, who suffers from cystic fibrosis, was prescribed Levaquin at Stanford, the medical center he had been treated at for many decades. He quickly noticed a big problem with his Achilles tendons. He called the docs. He stopped taking the drugs (Stanford was fine with that) and I think it saved him serious muscular damage. Please be very careful with Levaquin, regardless of your age or condition.
14
@Mill thank you!
One of the problems is the lack of exploring the context of a patient's issue. Drs in the US are not allowed the time, or perhaps do not have the inclination or training to ask questions. A pill is a quick answer. For example, for a few years I got a broad spectrum antibiotic for recurrent dental infection. I finally realized that an electric toothbrush was too harsh for me. For the past 4 years: No more infection since I switched to a soft manual toothbrush.
11
I was given levaquin pre-op, and suffered every side effect listed on the insert (except ruptured tendons). 20 years later I still suffer from tinnitus (32 decibels, 12,000 hertz) caused by the drug. It's debilitating.
13
@Robert Powell
No question the problems mentioned from taking fluoroquinolones are real. However, tinnitus is very prevalent among older adults and has multiple causes so attributing it to an antibiotic you took 20 years earlier is a stretch even if you remember becoming aware of it around the time you took the antibiotic.
7
Okay, seniors, no opioids for your pain. No antibiotics. Just roll over and die why don't you? We've gone a lifetime with these drugs and it seems cruel to withdraw them now.
8
@Ken
If you read the article and understand the issues behind overuse of antimicrobial drugs, you would understand that antibiotics as prescribed are frequently more harmful than helpful. And antibiotic resistance makes us all more likely to die when they are truly needed.
15
@Ken
I'm in my 80's and refuse all painkillers -- which doctors tried to push at me when I had cancer a few years ago; and again when I had a recent colonoscopy. I've broken bones on basketball courts, ski slopes, softball fields and while hammering nails -- still took nothing (well, a couple of glasses of wine once or twice.)
Happily drug free; not dead yet.
14
@Ken That was always my dad's prescription whenever we were sick as kids: "just hold your head under the water in the sink for 20 min. and you'll be fine." He'd probably be put in jail for saying anything like that now days.
6
I suffer from chronic prostatitis.Bad pelvic pain all the time.took opiods for many years.Nothing helps.housebound.I think over 20 years ago I did not get enough Cipro to kill the UTI infection.
5
In my experience MD’s are quick to prescribe, even when a tincture of time may be warranted. Also my general understanding is that dosing is by weight, not by age and perhaps slower metabolisms.
9
Drugs are metabolized by kidney and liver, so their level of function definitely also matters.
1
Had repeatedly UTI's so the doc put me on Cipro, I was good for 3 weeks after then another UTI, got on a Friday night, doc closed, went to an Urgent Care, that doc prescribed Bactrim because I couldn't remember the last antibiotic I took. Got another UTI 3 week later on a Friday night AGAIN, went to Urgent Care, the same doc gave me another round of Bactrim so I had taken antibiotics for essentially 3 months in a row. The result was chronic diarrhea for 6 months, no one got the connection between the antibiotics and the diarrhea, my doc ordered a colonoscopy but before, ordered a CAT can which showed a kidney stone, hence all the UTI's. I've lost almost all my hair because of antibiotics . BAD diagnosing, bad prescribing, BAD MEDICINE.
35
@Sher Fuller The probiotic L-reuteri prevents the bacteria that cause UTIs from attaching to the bladder wall. I got frequent UTIs (every 2-3 months) until I did some research and discovered L-Reuteri. I haven't had a UTI since then--about 5 years ago.
4
It's frustrating to see so many articles about the harms of antibiotics and nearly all of them ignore the collateral damage to the human microbiome, which is arguably the most worrisome detriment, as damage to our host-native microbiomes compounds over generations. Martin Blaser has written extremely important books & papers on this.
78
@MaximilianKohler
An example of a paper Martin Blaser wrote recently for the Journal of Cleveland Clinic: https://www.mdedge.com/ccjm/article/189671/infectious-diseases/our-missing-microbes-short-term-antibiotic-courses-have-long
6
@MaximilianKohler, Thanks for the link. Disruption of the micro biome is one side effect I worry about, especially from antibiotics. Although I've been a vegetarian for nearly 5 decades, I now eat plant based whole foods (no animal products, minimal to no processed foods, including low to no added sugar, oil, and salt) in part because of the beneficial effects on the intestinal micro biome (and my own health).
3
Three months ago I was bitten by a feral cat on the ring finger of my left hand. She also scratched that hand, but that was superficial. The bite, on the other hand, was so deep that I had trouble shaking her off my hand.
I immediately removed my wedding ring and treated the hand with soap and water, Betadine solution, small bandages, and a finger cot. I reported it to the shelter hierarchy.
I couldn't get in the next day, and by the day after the finger was swollen like a sausage and my hand was mostly red. He started me on antibiotics right away, but also cultured the pus to be sure it was the right drug, which it turned out to be.
The finger still is giving me problems, but I was very thankful for getting antibiotics right away. I no longer go to the doctor for earaches and cold symptoms until and unless they seem to be progressing to pneumonia. I'm thankful that there are still safe, effective antibiotics for folks like me who need them. Before antibiotics someone like me might have lost the finger or even more of the hand.
98
@Susan that happened to me 20 years ago, and at age 58 went to a doctor for the first time in over 15 years. He treated me with old-fashioned antibiotics and my hand was OK within days. That visit resulted in my having a routine checkup in which my stage IIIC breast cancer was detected. I was 58 and that was 14 years ago.
8
I was hospitalized for two weeks,a few years ago with sepsis and haven't completely recovered. I was unable to walk when I left the hospital.
The infection on my legs that preceded the sepsis had been continuing for 6 months. They were large boils several inches with, gaping wounds. The last I saw my GP, I was in tears. She rushed me into surgery to drain the wound and see the infectious disease specialist, who said the wounds were significant but nothing to worry about. I completed my 5 day of bactrim and never made it back for a followup. Emergency rooms in New York are required to test for sepsis, so I lived.
It was a terrifying experience, I think I could sue the doctors because the infectious disease specialist was actually pediatrician and no one mentioned the possibility of sepsis even though the infection was spreading into my vagina.
There is a risk in treating the public instead of treating the individual. I've met other older people who developed sepsis even though they we seeing a doctor about an infection.
Sepsis is a problem we need to avoid. There need to be better guideline for addressing infections and informing patient about potential hazards.
26
@swp Well, when patients' thought at the first hint of problem is "I think i can sue" is probably one of the, many, reasons, Drs. go with pills to cover their back. One cannot blame them with sue-happy patients all around. Medicine is not a fool proof science, individuals react sometimes in opposite ways to a medication. Also, people live longer with a myriads of problems, not always easy to diagnose which is which.
8
@June Sue-Happy? That's really a sick thing to say to someone who nearly died after being treated for 6 months for a standard staph infection --something that would have been cured with penicillin. Gaping wounds in my legs and vagina was pretty cut and dry. But, I didn't sue because sepsis is fast and I blame a system that passes a patient around to a different doctor on every visit. They were alarmed! They did more testing trying to find aids or some immune failure in the aftermath. The thing they didn't do was inform me that I was at risk for sepsis, very at risk. My system clearly had not been able to fight a standard staph and they spent more time (2 hours) trying to reassure me I would be OK than telling me about the warning signs of sepsis.
5
Took Levaquin three years ago, had every side-effect listed, and quit after three days on advice of friend who's a nurse. A cousin took it for the duration and ruptured a tendon.
Thanks, the next time I take it will be when I'm exposed to anthrax. Until then -- .
50
It seems to me that targeting ALL older adults will lead us to the same problems we are seeing with narcotics: those who have legitimate needs can't get them prescribed out of fear of misuse or worse. If the medical establishment really wants to make a contribution to antibiotic overuse why not start with the massive use of antibiotics in animals or 2nd and 3rd world countries where you don't need a Rx to get antibiotics. Just a visit to your neighborhood pharmacist.
28
@KF2
Actually, antibiotics are massively overused in US ‘First World’ animal husbandry. There’s a valid reason why Europeans won’t import our meat.
Your overall point is important. Having been a victim of over scrupulous avoidance of antibiotics, I’ve learned after three prolonged respiratory infections, one lasting over 4 months, that if you have lung disease, as I do, you will not recover without effective antibiotic therapy. This followed years of recovery from similar infections with no use of antibiotics. While they pose a risk to seniors, physicians need to be aware that many of us have significant comorbidities which will be exacerbated by conservative treatment, including the avoidance of antibiotics in treating serious UTIs.
36
I've taken amoxycilin for ear infections. Works well and no side affects.
10
@Molly K. - Amoxicillin works for you, but some people react badly to it. It's a form of penicillin, and some people are allergic. Everyone reacts differently to different antibiotics. It's important to keep a record of medications that have bad side effects for you, and share the list with every doctor who treats you.
2
@Molly K.
Ear infections have been shown to NOT generally need antibiotics at all. A nurse practitioner still wanted my kid to take them and I refused, having read the studies. He healed up just fine and has never yet been on antibiotics. They have done damage to my own health. All health practitioners must do better, and we must know more and know we can refuse such advice and find a new doctor as well.
4
I took Levaquin for a resistant sinus infection. It was a really bad bacterial infection -- I had asked the doctor to culture it -- and I must say that the Levaquin did take care of it. A week after I finished the medication, however, I started to limp on one side -- my Achilles' tendon -- then a couple of days later, I started to limp on the other side as well. Both Achilles tendons were severely strained, and I was afraid to even walk around for fear they would tear. I was a year before I recovered, with extensive physical therapy, and they've never been the same (previously had never had even a twinge from them in all of my 43 years.) This is a crippling injury; I tell everyone I know to avoid fluoroquinolones if at all possible. To be fair, the drug came with a black box warning about the risk of tendon problems. I just didn't think I'd be the one to get the side effect; who does?
162
@ED For a recurrent UTI in December, I was prescribed Levaquin. On day 9 of a 10 day prescription, I noticed my arms ached and my range of motion was limited. My doctor said to stop taking it, and to never take it again. While the Achilles tendon is most commonly affected by fluoroquinolones, other tendons also can be damaged. It's taken me months to recover. I'm 65, and I clearly fall in to the black box warning about this class of drugs. While I've read the risk of injury is rare, I know of a number of others who also have been adversely affected. I've never had a reaction to a drug. It's sobering, especially the association of FQs and aortic rupture.
28
I was prescribed 30 days of Levoflaxin for a bacteria infection. First my left forearm ached, then my right forearm. I spoke to specialty pharmacist and he advised it could linger for a year as a side effect. The drug didn't even work and I had to take Tybromycin for another month, but that worked. My arm still has tendonitis and I am now seeing an acupuncture doctor to ease that pain.
My advice is to not take Levoflaxin as I have know no one who says it works for them and many who have side effects.
45
@Rebecca
Levaquin saved my life when I was in the hospital with a very serious pneumonia. it’s not a drug to give out .ightly, but there are times when it’s necessary.
14
@Rebecca I had pneumonia in 2000. Prescribed Levaquin. No betterment of pneumonia but I was crying and shaking. 4 days later I called doc who changed me to Biaxin. Almost immediately I calmed down and pneumonia cleared up. I’ve taken many rounds of coprocessor with good results, but who knows what’s really happened.
4
@Anne @ Rebecca not coprocessor- cipro!
There is indeed a "black box warning" on this class of antibiotics. The problem is that the prescriber may not disclose this, or take the time to consider the risk factors. If your prescriber doesn't know your health history or your current health in detail, you may be at risk.
An elderly person who is already taking cardiac meds, or one who has pelvic floor issues, an older man with prostate issues, or anyone with arthritis would potentially be at greater risk for bad outcomes from the known side effects of flouroquilolones.
It could take time to figure out what the right antibiotic is, or even if there is a good reason to try wait-and see. Time that you must demand, because most practices want you out the door as quickly as possible.
If your parent is unable to communicate their concerns, please go with them to their appointment. When they injure their ankle or develop other problems from these drugs, the tendency will be to say "Well, old people have to accept these problems".
The truth is that these drugs can harm older people in ways that create pain and permanent disability. That black box warning is not a joke.
65
They can harm younger people too- it happened to me. Furthermore, the prescriber and another doctor then insisted “If you read the list of side effects you’ll just imagine you have every one. That’s typical of young ladies. Don’t read the side effect list! You do seem to be a worrier....try a Seroquel prescription?”
9
Antibiotic overuse is a problem for the general population, including children. I understand that fluoroquinolones have numerous risks that deserve to be highlighted. Here are a couple of places summarizing general concerns:
https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/antibiotics/art-20045720
https://my.clevelandclinic.org/health/articles/14275-antibiotics-overuse-and-unnecessary-use
https://www.johnshopkinshealthreview.com/issues/spring-summer-2018/articles/the-case-against-antibiotics
18
Get information, thanks!
1
All medications picked up from a pharmacy have a drug insert included. There is comprehensive information in them.
1
Have to take an antibiotic to visit the dentist if you have artificial joints. Elderly people probably have the most joint replacements.
6
@Porridge
This advice, as a general rule, is not accurate: https://www.mdedge.com/internalmedicine/article/132023/infectious-diseases/antibiotic-prophylaxis-artificial-joints . While there are specific circumstances where prophylactic antibiotics may be indicated, check with someone who knows.
19
@Porridge
Sorry, you were lied to:
https://www.lexi.com/individuals/dentistry/newsletters.jsp?id=march_10
11
@JSK
Thank you - this will be a help to people I know who have been told that antibiotic pre dental work is a must.
10