For Physicians

One of the most difficult aspects of suffering severe side effects with a fluoroquinolone is the rejection and denial from the allopathic medical community toward the patient. When I was hospitalized at UC Davis Medical Center in Sacramento, California, NONE of the physicians believed that my symptoms could be caused by Cipro. Not only was the possibility that Cipro could cause these severe reactions thoughtlessly rejected, but the fact that I had gleamed some of my information about Cipro from the web totally discredited me and my claims in the eyes of my physicians. Generally speaking, the web is regarded by the medical community as offering unreliable (even bogus) medical information and the doctors I spoke to at UCD refused to validate ANY information that did not come form the FDA or a reputable medical journal. I have a few things to say about that:

1) Just because it is on the web, does NOT mean that it isn’t true.

2) Just because it is published by the medical journals does not mean that it IS true.

3) The FDA is a reliable and comprehensive resource? Are you kidding me?

4) And finally, although the more severe reactions to fluoroquinolones are rare, THEY DO EXIST. Once you can wrap your head around the realization that a patient (generally healthy and of any age) can take an antibiotic and then suffer unimaginable and mysterious disabilities, you are on the path to being a better doctor.

If you are a physician and interested in helping one of my fellow floxies, please consider browsing this sample of articles. It is my hope that you may get a clearer picture of the documented and potentially fatal adverse reactions thousands of people are suffering from fluoroquinolones. And if you feel inspired, perhaps you will consider writing a case study of your own. The more material we can get published in the medical journals, the more validity this condition and these patients can receive.

In conclusion, thank you for thinking outside the box and for seeking insight to your patient’s suffering. I wish there were more doctors like you. Please share any useful perspectives in the comment area below, or if you are feeling generous, you could regularly post on the forum. And, if you are aware of any journal publications about FQ Toxicity, I would deeply appreciate your sharing them with me. I will happily publish them here or offer a link if one is available. Thank you.

1) Stahlmann R. Clinical toxicological aspects of fluoroquinolones. Toxicol Lett. 2002 Feb 28;127(1-3):269-77. PubMed PMID: 12052667


2) De Sarro A, De Sarro G. Adverse reactions to fluoroquinolones. an overview on mechanistic aspects. Curr Med Chem. 2001 Mar;8(4):371-84. Review. PubMed PMID: 11172695

3) Stahlmann R, Lode H. Toxicity of quinolones. Drugs. 1999;58 Suppl 2:37-42. Review. PubMed PMID: 10553703

4) Mehlhorn AJ, Brown DA. Safety concerns with fluoroquinolones. Ann Pharmacother. 2007 Nov;41(11):1859-66. Epub 2007 Oct 2. Review. PubMed PMID: 17911203

5) Hall MM, Finnoff JT, Smith J. Musculoskeletal complications of fluoroquinolones: guidelines and precautions for usage in the athletic population. PM R. 2011 Feb;3(2):132-42. PubMed PMID: 21333952

6) Liu HH. Safety profile of the fluoroquinolones: focus on levofloxacin. Drug Saf. 2010 May 1;33(5):353-69. doi: 10.2165/11536360-000000000-00000. Review. PubMed PMID: 20397737

7) Cohen JS. Peripheral neuropathy associated with fluoroquinolones. Ann Pharmacother. 2001 Dec;35(12):1540-7. PubMed PMID: 11793615

8) Leone R, Venegoni M, Motola D, Moretti U, Piazzetta V, Cocci A, Resi D, Mozzo F, Velo G, Burzilleri L, Montanaro N, Conforti A. Adverse drug reactions related to the use of fluoroquinolone antimicrobials: an analysis of spontaneous reports and fluoroquinolone consumption data from three italian regions. Drug Saf. 2003;26(2):109-20. PubMed PMID: 12534327

9) Kim J, Ohtani H, Tsujimoto M, Sawada Y. Quantitative comparison of the convulsive activity of combinations of twelve fluoroquinolones with five nonsteroidal antiinflammatory agents. Drug Metab Pharmacokinet. 2009;24(2):167-74. PubMed PMID: 19430173

10) Gottschalk AW, Bachman JW. Death following bilateral complete Achilles tendon rupture in a patient on fluoroquinolone therapy: a case report. J Med Case Reports. 2009 Jan 6;3:1. PubMed PMID: 19126191; PubMed Central PMCID: PMC2631494

11) Kelesidis T, Fleisher J, Tsiodras S. Anaphylactoid reaction considered ciprofloxacin related: a case report and literature review. Clin Ther. 2010 Mar;32(3):515-26. Review. PubMed PMID: 20399988

12) Vadlamudi RS, Smalligan RD, Ismail HM. Interaction between warfarin and levofloxacin: case series. South Med J. 2007 Jul;100(7):720-4. PubMed PMID: 17639754

13) Falagas ME, Rafailidis PI, Rosmarakis ES. Arrhythmias associated with fluoroquinolone therapy. Int J Antimicrob Agents. 2007 Apr;29(4):374-9. Epub 2007 Jan 22. Review. PubMed PMID: 17241772

14) Corrao G, Zambon A, Bertù L, Mauri A, Paleari V, Rossi C, Venegoni M. Evidence of tendinitis provoked by fluoroquinolone treatment: a case-control study. Drug Saf. 2006;29(10):889-96. PubMed PMID: 16970512

15) Wang S, Rizvi AA. Levofloxacin-induced hypoglycemia in a nondiabetic patient. Am J Med Sci. 2006 Jun;331(6):334-5. PubMed PMID: 16775443

16) Doussau de Bazignan A, Thiessard F, Miremont-Salamé G, Conri C, Haramburu F; Centres Régionaux de Pharmacovigilance. [Psychiatric adverse effects of fluoroquinolone: review of cases from the French pharmacologic surveillance database]. Rev Med Interne. 2006 Jun;27(6):448-52. Epub 2006 Mar 9. French. PubMed PMID: 16580096

17) O-Lee T, Stewart CE 4th, Seery L, Church CA. Fluoroquinolone-induced arthralgia and myalgia in the treatment of sinusitis. Am J Rhinol. 2005 Jul-Aug;19(4):395-9. PubMed PMID: 16171175

18) Gürbay A, Gonthier B, Signorini-Allibe N, Barret L, Favier A, Hincal F. Ciprofloxacin-induced DNA damage in primary culture of rat astrocytes and protection by Vitamin E. Neurotoxicology. 2006 Jan;27(1):6-10. Epub 2005 Aug 24. PubMed PMID: 16122804

19) Petitjeans F, Nadaud J, Perez JP, Debien B, Olive F, Villevieille T, Pats B. A case of rhabdomyolysis with fatal outcome after a treatment with levofloxacin. Eur J Clin Pharmacol. 2003 Dec;59(10):779-80. Epub 2003 Oct 24. PubMed PMID: 14576967

20) Oh YR, Carr-Lopez SM, Probasco JM, Crawley PG. Levofloxacin-induced autoimmune hemolytic anemia. Ann Pharmacother. 2003 Jul-Aug;37(7-8):1010-3. PubMed PMID: 12841809

21) Corps AN, Harrall RL, Curry VA, Fenwick SA, Hazleman BL, Riley GP. Ciprofloxacin enhances the stimulation of matrix metalloproteinase 3 expression by interleukin-1beta in human tendon-derived cells. A potential mechanism of fluoroquinolone-induced tendinopathy. Arthritis Rheum. 2002 Nov;46(11):3034-40. PubMed PMID: 12428247

22) Reactions to Cipro, Levaquin, and Other Fluoroquinolone Antibiotics

23) Emergency Medicine News:October 2008 – Volume 30 – Issue 10 – pp 16-18 Adverse Reactions to Fluoroquinolones

24) an article 2010 about cipro induced tendinopathy

25) new March 2011:






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