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Popular antibiotics implicated in nerve damage, says
study with B.C. links
North Vancouvers Christina Rey experienced mysterious arthritic
pain and weakness after taking ciprofloxacin in 2008
BY RANDY SHORE, VANCOUVER SUN AUGUST 22, 2014 1:14 PM
A popular class of oral antibiotics doubles the risk of experiencing
permanent nerve damage, according to new research published in the
journal Neurology.
Fluorquinolones are one of the most-prescribed classes of antibiotics in
B.C., often used in cases of respiratory and urinary tract infection, but
they have been implicated in a variety of serious side effects.
An Ontario group found a link with liver disease. We found a link with
retinal detachment and kidney disease, and now peripheral neuropathy.
These are pretty serious, nasty conditions compared with a more typical
antibiotic, which might give you a couple of days of diarrhea, said lead
author Mahyar Etminan, a drug safety researcher at the University of
B.C.
The most popular of these drugs, ciprofloxacin, mocifloxacin and
levofloxacin, are sold under the trade names Cipro, Avelox and
Levaquin.
The U.S. Food and Drug Administration last year ordered a warning be
added to the labelling on all fluoroquinolone drugs after receiving
anecdotal reports of peripheral neuropathy, which causes muscle
weakness, numbness and pain.
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In 2013-2014, 2.3 million prescriptions for oral antibiotics were filled in B.C.
Photograph by: Joe Raedle , Getty Images
N E W S O P I N I O N B U S I N E S S S P O R T S E N T E R T A I N M E N T L I F E H E A L T H T E C H N O L O G Y T R A V E L C A R E E R S D R I V I N G H O M E S C L A S S I F I E D S

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Etminans group sought to quantify the risk.
In the past couple of years, there were lots of cases reported to the
FDA of peripheral neuropathy, which is a condition in which the patient
experiences a pinching in the nerves, eventually interfering with their
daily activities, he said. Case reports are a powerful tool, but they are
at the bottom of the food chain in terms of scientific evidence.
North Vancouvers Christina Rey experienced mysterious arthritic pain
and weakness after taking ciprofloxacin in 2008, she said in an email
interview, but doctors were unable at the time to confirm the cause.
A second course of the drug prescribed earlier this year caused nerve
symptoms and pain to return, which are only now starting to ease seven
months later, she said. Rey is awaiting a referal to a neurologist, which
she hopes will confirm a diagnosis of peripheral neuropathy.
I am getting better with time, but im not sure if Ill ever be the same as
before, she said. I have somewhat come to terms with the fact that this
is the way things could be from now on.
The data for Etmanins most recent study were gleaned from medical
records of about one million American men 45 to 80 years old over a
decade. The researchers pulled records of men diagnosed with
peripheral neuropathy to determine if they had been prescribed
fluorquinolones. They compared the results with case controls and with
men prescribed finasteride, a drug not expected to increase the risk of
peripheral neuropathy.
Men who are on fluorquinolones, especially first-time users, were twice
as likely to experience peripheral neuropathy as men who were not.
An earlier study led by Etmanin identified 445 cases of retinal
detachment involving oral fluoroquinolone use in a cohort of 989,591
patients from B.C. who visited an ophthalmologist between January
2000 and December 2007.
The finding prompted Health Canada to issue a warning last year in the
Canadian Adverse Reaction Newsletter.
The effectiveness of the drugs may tempt physicians to use them, even
when alternative treatments are available, explained Etminan.
Fluorquinolones are a very broad spectrum, covering a lot of bacteria,
and they are very readily absorbed, providing the same concentration in
the body as intravenous antibiotics, so they may be used to avoid having
a patient in hospital, said Etminan.
Canadian doctors tend to use antibiotics in a more refined way than in
the United States. Physicians here are not as likely to prescribe
antibiotics. However, physicians need to know not to use these drugs
unless they have to, said Etminan.
rshore@vancouversun.com
===
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