Do doctors know what antibiotics they shouldn’t prescribe for simple infection?
It appears that most doctors don’t follow FDA regulations and especially don’t read updated regulations. There is an extended black box warning on all fluoroquinolone class antibiotics, which are:
- levofloxacin (Levaquin),
- ciprofloxacin (Cipro),
- ciprofloxacin extended-release tablets,
- moxifloxacin (Avelox),
- ofloxacin (Ocuflox)
- gemifloxacin (Factive)
- delafloxacin (Baxdela).
There are more than 60 generic versions of these antibiotics and so it is your job–the sick person–to check what you are getting! It is your health and your doctor is too busy to see patients to read FDA regulations… after all, it’s the FDA. Right? (‘nough politics!)
Over the past decade I wrote many articles on this topic: here, here, here, and then I also wrote a petition against their use for everything, see here, here. The black box was finally released, see here. Additional warnings on quinolones came forth, see here. Four years after my initial petition, the FDA sent a letter to me, see here, Lots more articles were published on this blog on this by me and then bang, a lawsuit decorated the quinolone class drugs, see here. One more article to share with you here.
What’s In the Name
Keep an eye on the word “floxa” somewhere in the generic name.
ciprofloxacin extended-release tablets,
Initial Discovery And What Happened Later
When the black box first appeared, it only stated potential damage to the tendons–especially the Achilles tendons–and tendonitis. The latest updated black box, as of 2018, contains a lot more warnings: risks of mental health and low blood sugar adverse reactions!
These drugs have been known to cause serious damage to many people. In fact, I have opened a Facebook group many years ago for people who have been hurt by these drugs. The damaged are called “floxed” and so the group name is Floxed on Facebook as well. We try to help but solutions are limited at this point. The damage appears to be to the mitochondria and no one seems to take it seriously enough to start research on what can help overcome mitochondrial damage.
Lately I see many doctors prescribing these drugs and I see many people getting hurt! Some of the injuries may be permanent!
What You Can Do!
Be sure to add all these drugs on the list of drugs that you are allergic to at your doctors’ offices. Also buy an allergy bracelet or card and list these antibiotics on your card as allergies. This way the doctors cannot just casually prescribe them to you for a simple UTI or a cold!
If you have serious pneumonia and your life is on the line, take it by all means! But if there are alternate treatments, be sure to have the FDA warning with you to remind your doctor that this drug can cause more harm than good!
I fought for passing this black box with all my might and the black box was passed! I was very happy to have been part of this effort! But I am very sad that doctors aren’t reading the FDA regulations, and hurt many people unnecessarily! Take your health into your hands! Print the FDA article out and take it with you to every doctor visit in the future!
Can You Rebuild Mitochondria?
Great question, no solid answers. Mitochondria are our energy factories in our cells, and when they die, so do we. The options are very limited. However, understanding how nutrition affects the health of our cells, how fasting, for example, can initiate autophagy, the state in which cells (and their mitochondria) get to be replaced, I think there is hope. I strongly recommend to move to a very low carbohydrate and high protein and fat diet because glucose metabolism is very hard on our body and our mitochondria. Fat and protein metabolism is much easier and produce much less reactive oxygen species, which are harmful for the mitochondria. So I recommend the ketogenic diet and lots of 2-3-day long fasting.
Comments are welcome, as always, and are moderated for appropriateness.
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I agree. Doctors do NOT keep up or be bothered with the black box warnings and administration constraints on fluroquinolones. Not only was I prescribed a 10 day, 750mg prescription of levafloxacin with prednisone (which increases the risk) at the spring age of 59, and without a confirmed infection much less a culture, but nobody, not the PCP nor the pharmacist said boo. Not even when I called about swollen ankles. Patients are brainwashed to “finish the full course of antibiotics” not to monitor for potentially permanent and life-threatening damages.
this ruined my life. confirmed infrasubstance tendon tears. I can’t stand in a shower for 5 minutes and can barely hobble around a 2br condo. Brain fog, anxiety, and tendon/ligament damage in at least a dozen places; I’d bet more like 20.
I’ve seen a host of doctors from sports med and ortho to PCP including one with a dual pharmacology background. Nobody gives a damn enough to even do cursory research.
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You are very correct and thank you for your comment. No one really cares because if they admit wrong-doing, class-action lawsuits fly up–some already have but I am not sure of the outcome. It is also in no one’s interest to keep you healthy. From my experience, most doctors (not all) only symptom-treat and never ever look for the root cause–such as a culture to see if you have gram negative or positive bacteria, each of which has very specific and successful antibiotics to get rid of.
But I think the biggest problem is somewhat resolvable. It is hard for people to educate themselves at the level of a doctor to learn what to do but some research can be had. I don’t know what infection you had but from the suggestion of culture I presume it was a urinary infection (UTI). A large percent of UTIs aren’t even caused by bacteria but by oxalates. Oxalates are needle-like microscopic tiny torture crystals that some people are more sensitive to than others.
While we all produce oxalates as a biproduct of our own metabolism, most oxalates that cause trouble by giving infection-like pain and burning are from eating plants. Many plants, some that are concentrated often too, such as almonds into almond milk or almond flour, and spinach, and most other greens that people are told to eat a lot of are chock full of oxalates than can be really harmful for those who have trouble excreting oxalates. 99% of kidney stones are oxalates mixed with calcium.
You may wonder what I would do in your case–I too had a torn Achilles tendon from quinolones–in my case Cipro. I ma completely cured by now though it took a few years. The antibiotics damage the mitochondria in the cells all over the body and without mitochondria to provide us with energy (ATP) we die. Hence, the purpose of our eating and whatever we do, really should focus around creating the best environment for our mitochondria!
Mitochondria don’t eat plants! In fact, they don’t eat carbs, or fat, or protein. They eat Acetyl-CoA, an enzyme that is specifically created for them and is ketone-like. They don’t care from what this Acetyl-CoA is made but you do! And that’s because if it is made from glucose (meaning you eat a diet high in carbohydrates, such as the standard American diet or a plant-based diet, then your body will be full of reactive oxygen species (ROS) becuase of the conversion that releases lots of heat from the oxygen and must be “put out” by antioxidants. Creating lots of ROS is harmful for your body and also for your mitochondria.
Your diet should be one with as little carbohydrates as possible–a carnivore diet (I found) is the best for fast recovery and also fasting. Fasting for longer than 2 days initiates a cellular recovery/replacement process (autophagy) and also provides healthy stem cells. So if you are floxed, your best way of eating is the carnivore diet of all animal-based diet and periodic 2+ days of fasting drinking only salted water. The supplements you may consider at TTTFD type B1 (Allithiamine, Lipothiamine, or Thiamax are the only 3 types), magnesium, CoQ10 in ubiquinol form, and eat a very high animal protein/animal fat diet.
On Facebook there are many groups for people who are floxed, including me, I have a very small group of floxed members: https://www.facebook.com/groups/Floxed
You are welcome to join the group and we will help you there.
Thank you for the suggestions. I hadn’t tried fasting though I do restrict all refined carbohydrates. A little oatmeal is the exception because I refuse to take statins which can further damage tendons.
I have heard of folks recovering from cipro toxicity. levofloxacin, particularly two 10 day does at 750mg, none. But I keep trying. At least one peer-reviewed study would indicate that levofloxacin and its parent, ofloxacin are the riskiest. Not that ciprofloxacin is any joke of course. And that’s the thing, right. If I can find that out in 15 minutes on PubMed but they can’t bother.
Last note: I left the prescribing doctor once my achilles were clearly damaged. He was inept given I called about bicep pain and swollen ankles. So the others I saw were in other networks and states and at no risk of a lawsuit. Even the state I lived in at the time of floxing had a solidly Republican legislature who had reformed tort laws and made it effectively impossible to sue for medical malpractice. Nope, the physicians I saw just didn’t know and didn’t care and sure as hell weren’t going to educate themselves. Which by all accounts I’ve read and heard from others floxed victims was typical to their experience. Not that there’s been any real research into flurouquinolone toxicity treatment protocols so even if they did a competent diagnosis, then what? As I see it this paradigm has created a state where thousands if not tens of thousands of floxed victims are effectively trying to treat themselves and that’s dangerous in its own right.
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FloxedanditSux if you want to get cured, you need higher cholesterol so I recommend you stop oatmeal. Not only is oatmeal blocking nutrients from the meats you eat but it is also an amazing amount of carbs. The excess carbs convert to fat by the liver and also captured in your but and form the very unhealthy super dense small size cholesterol particles, which fit into fewer LDLs.
Don’t for a moment think that a low LDL has any benefit, and here is why: LDL is not cholesterol but a lipoprotein in which cholesterol particles travel. I just recently wrote about this: https://cluelessdoctors.com/2021/11/11/do-we-understand-cholesterol/ this article is a must read for you and for your doctors. LDL carries cholesterol and all LDLs are the same size. So how many cholesterol particles can you pack into an LDL ball if you have small and dense (sick) cholesterol particles versus if you have large ad fluffy cholesterol particles?
If you can pack 1000 cholesterol particles into one LDL, is that any better than if you only can pack in 100 per LDL because your cholesterol is large and fluffy? In in the case of the healthy large cholesterol, you will have 10 times as many LDLs but you have a much healthier cholesterol. So think about this before you consider that you want to keep your LDL low so that you don’t need statins. Also consider that LDL carries all fat-soluble vitamins: A, E, and K2. A lower number of LDLs will also carry less of these essential vitamins. And finally LDL is part of the immune system. The lower your LDL count, the weaker your immune system.
Understanding all these, do you still want to eat oatmeal to lower your LDL? Is it worth it? That oatmeal is preventing you from healing your tendons.
By the way, I live in California, a VERY Democratic state that made suing also impossible. I don’t think this has anything to do with the political governance of the state how much they block medical lawsuits.. Also consider that you can only sue brand name pharmaceuticals and only if you took the brand name drug when you got hurt. The generic is made by other companies and there is absolutely no way to sue them. They refer back to the brand name that :we just do what they do” and the brand name says “we are not responsible because they made the generic and something is different” (coating is usually different). So you cannot sue anyone pretty much anywhere in any state.
It is also not malpractice if these drugs are still supported by the FDA and the black box just “suggests” to not use it. The doctor can override that by suggesting that it was necessary.
So you have to accept that the only thing you can do is change your lifestyle, make yourself healthier, give yourself the most opportunity to heal.
Angela, I found this, which pushes the first warning back to 2008.
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Thank you. This is the one I am referring to in the article about the admission of these drugs causing tendon rupture and tendonitis. There were more citizen petition periods after for more issues and my fight was actually to have the FDA remove Cipro (and alike) from “common use” for simple things, like UTIs and simple infections for which other antibiotics are available. I achieved that and, as you can see on the link I attached to one of the letters I got from the FDA, they have posted a restrictive use on it for only those situations when there were no alternatives. This 2008-paper was the first step. We have come now far from this as the black box is now extensive with warnings. Here is the most recent (I think) full label for cirofloxacin (Cipro): https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019537s086lbl.pdf and in the black box on this:
WARNING: SERIOUS ADVERSE REACTIONS INCLUDING
TENDINITIS, TENDON RUPTURE, PERIPHERAL NEUROPATHY,
CENTRAL NERVOUS SYSTEM EFFECTS AND EXACERBATION
OF MYASTHENIA GRAVIS
See full prescribing information for complete boxed warning.
• Fluoroquinolones, including CIPRO®, have been associated with
disabling and potentially irreversible serious adverse reactions
that have occurred together (5.1), including:
o Tendinitis and tendon rupture (5.2)
o Peripheral neuropathy (5.3)
o Central nervous system effects (5.4)
Discontinue CIPRO immediately and avoid the use of
fluoroquinolones, including CIPRO, in patients who experience any
of these serious adverse reactions (5.1)
• Fluoroquinolones, including CIPRO, may exacerbate muscle
weakness in patients with myasthenia gravis. Avoid CIPRO in
patients with known history of myasthenia gravis. (5.5)
• Because fluoroquinolones, including CIPRO, have been associated
with serious adverse reactions (5.1-5.15), reserve CIPRO for use in
patients who have no alternative treatment options for the following
o Acute exacerbation of chronic bronchitis (1.10)
o Acute uncomplicated cystitis (1.11)
o Acute sinusitis (1.12)