Cipro And Side Effects

[tex]

Hi All,

Most of us have had exceptionally good results with Ciprofloxacin. Not only does it normally not trigger D for us, (like many other antibiotics), but if we are reacting before we start taking it, it will usually end the flare, and prevent D from recurring, until a few days after the treatment ends.

My brother doesn't have MC, but he had an attack of diverticulitis, last weekend, and so on Monday, his doc prescribed a combination treatment of Cipro and metronidazole, (better known by the brand name Flagyl). By day 4, the infection seemed to be pretty well under control, with the symptoms mostly gone, but when he and his wife went dancing that night, he started noticing tendonitis, just below his left knee. It got so bad that after the first few dances, he had to sit out the rest of them. The next day it was worse, and by bedtime, his knee was so swollen and painful that not only could he not sleep, but when he tried to get out of bed, to see if he could get some sleep sitting in a lounger, the pain become so severe that he was concerned that he might pass out. His leg felt burning hot, and the pain was so intense that he was afraid that the tendons or muscles were actually going to rip apart. He took a couple of aspirin, and tried a heat pad at first, and then ice, and finally he did manage to get a little sleep sitting in a lounger.

The next day, he stopped taking the Cipro, of course, and he took it easy all day, (he didn't have much choice, since he had to use crutches to get around), and the swelling and pain seemed to be less of a problem.

I've never heard of a reaction to Cipro, that became so severe, so quickly. I thought it was a risk, mostly for people who used it long-term, or repeatedly. I don't think that he had ever used it in the past, and he certainly won't be using it in the future. Anyone ever hear of such a fast, severe reaction to Cipro?

Tex

[Gloria]

Wow - that was quite a quick and severe reaction! I thought tendonitis was a risk with Cipro primarily for those of us taking a steroid.

I'm sure you were the one who advised him it could be the Cipro. If so, he's fortunate that you were able to determine the cause of his agony. I'm glad he's getting better.

Gloria

[Polly]

Mornin'!

I'm glad your brother is on the mend. Is this the very nice man who kept me posted on your hospital progress? If so, say hi from me, please.

My impression is that the tendonitis can occur at any time - even weeks or more after stopping Cipro.

Love,

Polly

[tex]

Gloria,

Actually, the pharmacist had pointed that out to him when he picked up the drugs. He was given a 4 or 5 page printout, with much of the critical stuff, (warning about the risk of tendonitis), highlighted. He had already decided that the Cipro had to be the main problem, but he wasn't sure whether to stop taking everything, or just the Cipro. I advised him to just cut out the Cipro, and check with his doctor, today. At least, I don't think that the metronidazole would aggravate the problem.


Polly,

Yep, he's the one. I'll certainly tell him that you said "Hi".

Thanks.

Love,
Tex

[Gayle]

Tex,

As Cipro and Levaquin are both Fluoroquinolones, I would wonder if the well known and documented increased risk for tendonitis and/or tendon rupture, and other related issues with Levaquin, doesn’t apply to some degree with all the Fluorquinolones. (But with a different degree of probability of occurrence between the different generations of these drugs)

Or perhaps another way of saying this – there may be an increasing risk of occurrence with the 3rd generation (Leviquin being in that camp) in relation to the earlier 2nd generation drugs (Cipro being in this group). But tendon issues should be understood to occur with a some degree of probability with all the Flouroqunilones??

Should anyone be really at this?

Perhaps it would be advisable to limit one's more strenuous activities - such as dancing - while taking one of these drugs???

It would be interesting if one could really know the statistics of reported occurances. Once again such a story points out a good reason for taking any antibiotic only when absolutely indicated. All antibiotics always represent the old double edged sword of good and bad (or) risk and reward.


Gayle

[tex]

All drugs carry statistical risks. There are no absolutely risk-free drugs, that I'm aware of. We always have to weight the benefits against the risks. Doctors, of course, see this in a different light. For them, it is virtually always worth the risk, because if a patient suffers adverse side effects, then they will need a prescription for a remedy.

Tex

[Gayle]

Tex,

Gayle said --

All antibiotics always represent the old double edged sword of good and bad (or) risk and reward.

Tex said --

There are no absolutely risk-free drugs, that I'm aware of. We always have to weight the benefits against the risks.

I see these 2 statements as saying the same thing. Maybe I'm .
Tex said --

Doctors, of course, see this in a different light ...

.
Personally speaking, I am just not as bitter and angry toward the medical establishment as this statement suggests you may be.

The larger issue is – IMHO – that the average American today either does not understand the concept of risk, or does not accept the concept of risk, and does not think risk should ever be in any way a part of their life. OR -- that they should be, in all ways, insulated from the possibility of any risk (whatever that may be).

Possibly you understand the reasons for this pervasive cultural attitude better than I do. But, I really do not believe that the cause of this attitude is ALL iatrogenic.

And -- with then next (4th) generation of Floroquinologs in the pipeline, the tendon risk is something people should make themselves familiar with and at least try to understand. Again just MHO.


Cheers,
Gayle

[Polly]

Gayle,

I couldn't agree with you more about the risk issue. I think people have forgotten that life IS risky, every minute of every day. The fact that the great majority of OB-GYNs get sued is an example. Obviously, they are not all incompetent. It's just that people now believe that they are "guaranteed" a healthy, full-term baby, especially if they have taken their prenatal vitamins, avoided alcohol and nicotine, and kept all of their appts. Somehow we have come to believe that we can control all outcomes, and this simply isn't true. There can be bad luck, genetic/environmental issues, human error, and quite often, no known reason for a less-than-ideal outcome. IOW life is a crap shoot.

Love,

Polly

[tex]

Gayle,

Actually, Gayle said more than:

All antibiotics always represent the old double edged sword of good and bad (or) risk and reward.

Once again such a story points out a good reason for taking any antibiotic only when absolutely indicated. All antibiotics always represent the old double edged sword of good and bad (or) risk and reward.

Sorry if the redundancy bothered you, but the reason why I rephrased your statement, was because when I read your post, you left me with the impression that you feel that antibiotics should only be used in situations where they are absolutely necessary, in order to save a life. (What else could absolutely indicated imply?)

I happen to feel that there are many other situations where the use of antibiotics is not only justified, but highly advisable. Waiting until an antibiotic is essential, in order to save someone's life, is waiting a bit too long, IMO. It should have been used long before that point. As Polly so aptly pointed out, there is no way that we can avoid some degree of risk, no matter what we do, and that concept is true, every day of our life, in virtually everything we do. Obviously, one of the biggest reasons why medical care is so expensive, is because so many people are not willing to accept that life is filled with risks. Whenever something goes wrong, they look for someone, (besides themselves), to blame.

For example, if the surgical team hadn't dosed me with antibiotics, before, during, and after, both of my emergency abdominal surgical procedures, I very likely wouldn't be here to argue with you about this point. There was certainly some degree of risk involved with using those antibiotics, but I'm extremely glad that they didn't choose to wait until those antibiotics were necessary, in order to save my life, because by then, I might not have been strong enough, to have been able to do my part.

Personally speaking, I am just not as bitter and angry toward the medical establishment as this statement suggests you may be.

Actually, I'm not anywhere near as bitter and angry toward the medical establishment as you seem to think I am. The statement that you are referring to was a joke, silly. What did you think the meant?

I might complain about some of the details of the way they go about their business, now and then, but doctors have absolutely, (without question), saved my life on at least 3 occasions, over the years. Trust me, I am most definitely not "bitter and angry toward the medical establishment". I owe my life to them. I just happen to feel that some of them could definitely afford to "polish their act", a bit.

Oh, and one more thing - to a farmer, casual dancing is definitely not qualified to appear on any list of strenuous activities. My brother would laugh himself sick, if someone were to tell him that. LOL.

Tex

P. S. Since you brought it up, iatrogenesis is the third leading cause of death, in the United States. I've been aware of that fact for years, but I haven't allowed it to get in the way, whenever I needed medical care. As Polly says, "Life is a crap shoot".

[Gabes-Apg]

to add to the topic of risks

do you think that the medical profession as a group are highlighting the risks to the patients? giving them adequate information to asssess the risks and for them to make an informed decision?

are they highlighting lifestyle habits (excercise, eating, family life, work stresses) to incorporate that into the assessment?

[tex]

do you think that the medical profession as a group are highlighting the risks to the patients? giving them adequate information to asssess the risks and for them to make an informed decision?

Well, sometimes they do.

are they highlighting lifestyle habits (excercise, eating, family life, work stresses) to incorporate that into the assessment?

I have to say that my PCP does a very good job of that.

Tex