These articles are the worst

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Exactly. I just think that these type of blogs/articles induce fear mongering among people who don't know that these types of reactions are quite rare.
 
This quote about sums it up (in reference to fluoroquinolones)

"they actually damage the DNA mitochondrial repair cells."

Much like the rest of the article, this statement is sort of almost accurate, but is really just a lot of out of context medical Mumbo jumbo being explained by someone with an axe to grind and no understanding of medicine.
 
This quote about sums it up (in reference to fluoroquinolones)

"they actually damage the DNA mitochondrial repair cells."

Much like the rest of the article, this statement is sort of almost accurate, but is really just a lot of out of context medical Mumbo jumbo being explained by someone with an axe to grind and no understanding of medicine.

Yep. Didn't have time earlier to quote **** from it, but yeah that sums it up. I love it when the general public knows more about abx than everyone else.
 
I dunno, considering the side effects and risk benefits of treatments recommended to you seems like a good suggestion to me
 
is cipro even considered a first line choice to give for a lot of every day patient complaints? (pre-clinical student here)
 
Why? Fluouroquinolones can cause tendonitis, she writes an article about how she got tendonitis from a fluouroquinolone, she recommends you ask for other antibiotic therapy or consider other options, everyone goes home happy.
Probably because the kind of person who reads this and takes it seriously doesn't say, "it's fine, I'll take another antibiotic." They probably don't know that there is more than one type of antibiotic. We train doctors because there is too much information out there to be well-informed about how to treat yourself medically without dedicating years of your life to it.
 
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The FDA's warning reiterates exactly what she shared. FDA Drug Safety Communication: FDA updates warnings for oral and injectable fluoroquinolone antibiotics due to disabling side effects . Also, the damage isn't as rare as it sounds. NCBI has done numerous studies on the cellular changes associated with Fluoroquinolones. In this one, they exposed human tendon to various Fluoroquinolone antibiotics, and all of them showed changes to the cellular matrix. Fluoroquinolones cause changes in extracellular matrix, signalling proteins, metalloproteinases and caspase-3 in cultured human tendon cells. - PubMed - NCBI . This NCBI study addresses Mitochondrial toxicity Fluoroquinolone-related neuropsychiatric and mitochondrial toxicity: a collaborative investigation by scientists and members of a social network. - PubMed - NCBI . This site addresses the fact that only roughly 10% of adverse side effects are reported to the FDA annually A Closer Look at FDA’s Adverse Event Reporting System – PSQH . CBS did a story that states "FDA database of adverse effects and found 3,000 deaths and 200,000 complaints of serious effects associated with Levaquin and similar drugs." That story is here Levaquin: FDA fails to disclose additional serious side effects of antibiotic linked to deaths . Also Doctors aren't being formerly notified of the warning changes Doctors may not hear new warnings about powerful antibiotics . I have 3 pages of NCBI links to studies done dedicated to Fluoroquinolone side effects, and another page of various medical studies dedicated to sharing this information. I wouldn't know much though, I only wrote "the worst," blog post cited here. I will be on the radio this Saturday, speaking with Dr. Bonati, of The Bonati Spine Institute. Dr. Bonati is the first spine surgeon to get approval from the FDA for use of a laser in spine surgery. If you would like to listen, you can find that here: Bonati Spine Institute & American Medicine Today Listen to Newsradio 970 WFLA Radio Live - Tampa Bay's News, Traffic, & Weather
My segment is actually scheduled for our Saturday, May 6th show. I am the first segment, right at 12pm EST.
However, there are some affiliate stations throughout the weekend where listeners can also hear the show.
Saturday 5/6/17 on Real Radio 104.1 7am, WCCF AM1580 11am, Naples' FM Talk 3pm and
Sunday 5/7/17 on 102.5 THE BONE 10am, WMMB 10am, AM 1510 WMEL 10am and KXNT Newsradio 10am.
I was going through nursing school before this happened. Believe it or not...I even know there is more than one antibiotic family.
 
Antibiotics as an entire class of drugs are over prescribed and many of the newer more potent ones can be extremely detrimental to health while the older ones are becoming obsolete in the antibiotic resistance battle. As someone who wants to be/is a doctor; IMO it is hypocritical of OP to ask that a patient be silent of her experience because it conflicts with his/her view of medicine. There is nothing wrong with a bit of pressure on our profession to move forward for the sake of our patients, even if it is anecdotal in nature, Because these emotional experiences, like it or not are what the masses will respond to far above and beyond our understanding of actual science and statistics.

Side note. I found this review extremely interesting on the topic and it's something that is becoming highly exciting and revamped at least in the academic setting. Call it wishful thinking but i'd love to see this science move forward: Phage treatment of human infections
 
Antibiotics as an entire class of drugs are over prescribed and many of the newer more potent ones can be extremely detrimental to health while the older ones are becoming obsolete in the antibiotic resistance battle. As someone who wants to be/is a doctor; IMO it is hypocritical of OP to ask that a patient be silent of her experience because it conflicts with his/her view of medicine. There is nothing wrong with a bit of pressure on our profession to move forward for the sake of our patients, even if it is anecdotal in nature, Because these emotional experiences, like it or not are what the masses will respond to far above and beyond our understanding of actual science and statistics.

Side note. I found this review extremely interesting on the topic and it's something that is becoming highly exciting and revamped at least in the academic setting. Call it wishful thinking but i'd love to see this science move forward: Phage treatment of human infections


Edit: Plus i'd much rather have patients who are aware of the downsides of antibiotics looking to me for reassurance than one who comes in demanding an instant cure for something that is self limiting or viral in nature.
 
I don't see anything wrong with this article. FQ have very serious side effects, the package insert even says so. A lot of patients will downplay the package insert if the doctor does not seem concerned about it. A lot of people take several courses of these without issue. Some people take 1 course and it can seriously hurt them. Do you think side effects do not exist?

The tendonitis can be debilitating. The peripheral neuropathy can destroy someone's livelihood. They may be rare, but many physicians do not talk about these effects with their patients and several do not even know about the latter, which can be caused with only a few doses of the medication and can be permanent.
 
This quote about sums it up (in reference to fluoroquinolones)

"they actually damage the DNA mitochondrial repair cells."

Much like the rest of the article, this statement is sort of almost accurate, but is really just a lot of out of context medical Mumbo jumbo being explained by someone with an axe to grind and no understanding of medicine.
As an MS-1, most of what you say is out of context too.
 
Of course these side effects exist. That isn't my point at all. I've read the labels, and a few studies as well. My point is that this person is taking anecdotal evidence and suggesting that EVERYONE apply it to their situation. And by the way @B_52, I'm curious why you think it is appropriate to encourage the masses to use anecdotal, emotional evidence. This train of thought isn't so far off from what the anti-vaxxers promote every day.

TBH Floroquinolones are overprescribed according to the antibiotic stewardship pharm D who taught us. They also cause the effects she described.

Antibiotics as an entire class of drugs are over prescribed and many of the newer more potent ones can be extremely detrimental to health while the older ones are becoming obsolete in the antibiotic resistance battle. As someone who wants to be/is a doctor; IMO it is hypocritical of OP to ask that a patient be silent of her experience because it conflicts with his/her view of medicine. There is nothing wrong with a bit of pressure on our profession to move forward for the sake of our patients, even if it is anecdotal in nature, Because these emotional experiences, like it or not are what the masses will respond to far above and beyond our understanding of actual science and statistics.

Side note. I found this review extremely interesting on the topic and it's something that is becoming highly exciting and revamped at least in the academic setting. Call it wishful thinking but i'd love to see this science move forward: Phage treatment of human infections

I don't see anything wrong with this article. FQ have very serious side effects, the package insert even says so. A lot of patients will downplay the package insert if the doctor does not seem concerned about it. A lot of people take several courses of these without issue. Some people take 1 course and it can seriously hurt them. Do you think side effects do not exist?

The tendonitis can be debilitating. The peripheral neuropathy can destroy someone's livelihood. They may be rare, but many physicians do not talk about these effects with their patients and several do not even know about the latter, which can be caused with only a few doses of the medication and can be permanent.
 
Of course these side effects exist. That isn't my point at all. I've read the labels, and a few studies as well. My point is that this person is taking anecdotal evidence and suggesting that EVERYONE apply it to their situation. And by the way @B_52, I'm curious why you think it is appropriate to encourage the masses to use anecdotal, emotional evidence. This train of thought isn't so far off from what the anti-vaxxers promote every day.

No she is not using anecdotal evidence, she is describing her story then linked a bunch of articles. There is an FDA warning about the peripheral neuropathy that was only put on the labels in the last few years based on reports although it has been on the market for decades and tendonitis is a known side effect. She is begging patients to ask for and seek alternatives. When you study this, you kind of say tendonitis does not sound so bad. Most students probably skim past peripheral neuropathy if its even there. This patient, if we assume it is due to the FQ for the sake of argument, had her entire life flipped upside down because of it. She is telling other patients her story and asking them to ask for a different antibiotic. She literally puts in there "ask for alternatives." When an athletic patient younger than yourself comes to you with debilitating neuropathy after taking a course, you can tell the patient not to warn family and friends because after all, that would be anecdotal.

There is no evidence for the anti-vaxers. There is plenty of evidence for the fluoroquinolone toxicity, and it can occur after a few doses of the drug. Read the FDA report.
 
I think you misunderstood what I said. I wasn't comparing this woman to anti-vaxxers at all, but I was concerned that the other user thought that it was appropriate to encourage patients to think anecdotally instead of scientifically.......... This woman does have a legitimate point and there is definitely evidence to back up her claims. I don't doubt that what she experienced was from the antibiotics, although we can't be sure.
The main problem with the article from my point of view is that it seems intentionally dramatic and makes it sound as though these drugs are death in a bag.
No she is not using anecdotal evidence, she is describing her story then linked a bunch of articles. There is an FDA warning about the peripheral neuropathy that was only put on the labels in the last few years based on reports although it has been on the market for decades and tendonitis is a known side effect. She is begging patients to ask for and seek alternatives. When you study this, you kind of say tendonitis does not sound so bad. Most students probably skim past peripheral neuropathy if its even there. This patient, if we assume it is due to the FQ for the sake of argument, had her entire life flipped upside down because of it. She is telling other patients her story and asking them to ask for a different antibiotic. She literally puts in there "ask for alternatives." When an athletic patient younger than yourself comes to you with debilitating neuropathy after taking a course, you can tell the patient not to warn family and friends because after all, that would be anecdotal.

There is no evidence for the anti-vaxers. There is plenty of evidence for the fluoroquinolone toxicity, and it can occur after a few doses of the drug. Read the FDA report.
 
When you study this, you kind of say tendonitis does not sound so bad. Most students probably skim past peripheral neuropathy if its even there. This patient, if we assume it is due to the FQ for the sake of argument, had her entire life flipped upside down because of it.

Still a pre-med, but I can easily see myself falling into this. Thank you for sharing this perspective!
 
I think you misunderstood what I said. I wasn't comparing this woman to anti-vaxxers at all, but I was concerned that the other user thought that it was appropriate to encourage patients to think anecdotally instead of scientifically.......... This woman does have a legitimate point and there is definitely evidence to back up her claims. I don't doubt that what she experienced was from the antibiotics, although we can't be sure.
The main problem with the article from my point of view is that it seems intentionally dramatic and makes it sound as though these drugs are death in a bag.

It is dramatic for this patient and several others who have experienced it... these patients feel like they would rather have no had their infection treated than dealing with the effects of the medication itself... that should not be discounted. I think you're being dramatic with "these articles are the worst." She didn't even have the usual buzz phrases to piss us off. She did not talk about the pharmaceutical industry (I don't think at least) or how doctors are careless lol. She's putting a warning out there that the FDA pretty much agrees with.

Look at some package insert highlights:
Levaquin (Levofloxacin) FDA Package Insert & Drug Facts - Iodine.com
"warning: serious adverse reactions including tendinitis, tendon rupture, peripheral neuropathy, central nervous system effects and exacerbation of myasthenia gravis"

"Fluoroquinolones, including LEVAQUIN®, have been associated with
disabling and potentially irreversible serious adverse reactions that have occurred together"

"Because fluoroquinolones, including LEVAQUIN, have been associated with serious adverse reactions, reserve LEVAQUIN for use in patients who have no alternative treatment options for the following indications:


    • Uncomplicated urinary tract infection (1.12)
    • Acute bacterial exacerbation of chronic bronchitis (1.13)
    • Acute bacterial sinusitis"
Sounds dramatic to me. Also sounds pretty much like what the patient was trying to say. Anyway I'm sure you're going to defend your thread to the end and some people here might support it, but I mean, when the package insert agrees with the patient and you still call the patient out, that goes too far for me and I'm known for being a bigtime prick on these boards.
 
As an MS-1, most of what you say is out of context too.

I will not be accepting medical advice from anyone who says a drug will be "actually damaging the DNA mitochondrial repair cells"

Sorry but I don't see how what I said is out of context in any way.
 
Believe it or not...I even know there is more than one antibiotic family.

Hello Mrs. Moser,

Congratulations on writing a book, having it published and one that appears to be selling. Kudos to you ! Many of us writers on these boards dream of having a book published so you have beat us to the punch. Good for you. The foto of you and your family on Amazon is beautiful. You look like a lovely woman, you have a very handsome husband and your children look adorable. You are very rich and blessed.

I apologize for the nasty comments some have written about you. The internet, as you know as a blogger, lowers peoples inhibitions and show the ugly side of the human potential. Our current culture is very dark precisely because people have lost any sense of self-regulation.

It would help if you rewrote your blog and corrected some errors. I write this charitably: it has many grammatical mistakes, poor attribution and your emotions run high from start to finish of the article which detract from your objective critique of FQs. These minimize your hopeful message which is why, in part, you have received the arrows others have sent your way on SDN

Additionally you never stated how you know that FQs caused your medical problems. You never stated that physicians told you the blame lies with FQs. As a nursing student you know that other factors may be involved (i.e. polypharmacy, Cytochrome P450, enzyme deficiencies, rapid/slow metabolizers, etc). FQs do in fact result in rare complications. Aspirin has been on the market for even more decades and that too causes complications. Removing Aspirin and FQs from the market would be a dis-service to the global community. It would be helpful if you provided documentation from your physicians that state clearly your medical problems are a result of FQs, e.g. pathology reports, laboratory records, medical letters (personal info redacted), etc.

You are right with regard to FQs being over-used. I had a career in the biotech industry and interfered with thousands of physicians in the clinical setting. Physicians are creatures of habit, much like everyone else. Historically FQs have been written empirically by physicians for many infectious settings because they provide broad coverage. Empiric treatment is important. It is also important to switch the ABX from the "big gun" to a narrower spectrum ABX once the physician receives the microbiology report that demonstrates the bug. It is important to use the appropriate ABX for the causative pathogen and not use a "big gun" for everything.

In the early 2000s FQs became a "one size fits all" for community based physicians (vs hospital based physicians). Community physicians are often criticized by Infectious Disease Specialists for contributing to ABX resistance because of their abusing them empirically and not switching ABX once they learned of the microbiology report results. I used to sponsor lectures on antibiotic resistance trends in hospitals in my region of the country, using the Antibiograms of each individual institutional setting. I would acquire the last 5 Antibiograms from the microbiologists at the major hospitals in my region, and deliver presentations or sponsor recognized experts in their fields, to physicians in their hospitals based on their hospital antibiograms reflecting the resistance trends for the last 5 years. The Microbiologist and Chief Clinical Pharmacist partnered with me to educate physicians on which Abx were most efficacious for each organism (e.g. Strep. pneumo, E. coli, Pseudomonas, etc) and which were failing in their setting. Sadly most physicians at the time in hospitals did not refer to their Antbiogram which were provided by the Microbiologist year after year for free. FQs was one of those Abx that exhibited resistance with E. coli (e.g. UTI) because physicians were overusing them in the community. Not too far behind FQs showing resistance trends during those years were Macrolides (e.g. Zithromax/Azithromycin and Biaxin/Clarithromycin). There was a time when "Z-pack" was practically a household name. It was the number 1 Abx used in America for one year thanks to Community based physicians. So yes, FQs are "big guns" and were over-used at one time. Likewise with other ABX classes.

Drugs come and go. There was a time I was delivering non-stop lectures to ER physicians, Hospitalists, Intensivists and hospital based physicians on IV/IM ABX with regard to QTc prolongation, hyperglycemia, hypoglycemia and various other AEs. Macrolides were presenting with QTc prolongation in my region of the country at the time. Additionally Macrolides and Statins show a higher likelihood of muscle injury (Rhabdomyolysis) when used together in some people. One of the major local hospitals had a death in the hospital allegedly because of a FQ that is no longer available on the market: Tequin (Gatifloxacin) marketed by Bristol Myers Squibb. That event caused panic in that institution and soon word spread about the dangers of Tequin. BMS was salivating at the time at the prospect of taking market share away from Cipro and Levaquin with Tequin. Medicine is a business. However, in time the FDA sent one of their infamous "Dear Doctor letters" on the dangers of Tequin and BMS quietly removed their once lauded FQ from the market because of hyperglycemia and hypoglycemia. That was a nail in the coffin to BMS because their pipeline was dry and they had lost patent exclusivity to many of their drugs (e.g. Pravachol, Zocor, Taxol, etc). Tequin had many hopes but its removal from the market showcased the problems with the class of FQs in some people.

In the case of Cipro, Levaquin, Avelox, they have served the global health population well just like Aspirin. Side effects happen with all medications. If you want to reach a wider market in your messaging about the dangers of FQs, I would suggest reviewing your blog, and consider making some of the corrections I mentioned earlier. Perhaps, with proper messaging, you can publish another book. Why not? There's an audience for every message.

Again, congratulations on publishing a book. Your family looks lovely and I pray God blesses you and your family a hundredfold. Pray for physicians and physicians in training. You have passion and that is a gift. May we all be as passionate about medicine and doing our homework.

Blessings
 
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I see your point, and there are different ways to view this situation. I think that @cellsaver summed it up nicely below. And, as I'm sure you are aware, many drugs have package inserts that sound equally ominous (if not more so) so it isn't very impressive to just copy and paste those. I have to believe that this is a risk management situation. The likelihood of tendon rupture is quite rare (0.14-0.4% in general population, higher in patients with comorbidities). I guess at the end of the day, I'm just not impressed. Extravasated amio can eat flesh, daptomycin kills kidneys, and and young otherwise healthy people on levaquin VERY RARELY rupture tendons. It doesn't mean that they shouldn't be used. I'll agree to disagree. This isn't flame-war material.

It is dramatic for this patient and several others who have experienced it... these patients feel like they would rather have no had their infection treated than dealing with the effects of the medication itself... that should not be discounted. I think you're being dramatic with "these articles are the worst." She didn't even have the usual buzz phrases to piss us off. She did not talk about the pharmaceutical industry (I don't think at least) or how doctors are careless lol. She's putting a warning out there that the FDA pretty much agrees with.

Look at some package insert highlights:
Levaquin (Levofloxacin) FDA Package Insert & Drug Facts - Iodine.com
"warning: serious adverse reactions including tendinitis, tendon rupture, peripheral neuropathy, central nervous system effects and exacerbation of myasthenia gravis"

"Fluoroquinolones, including LEVAQUIN®, have been associated with
disabling and potentially irreversible serious adverse reactions that have occurred together"

"Because fluoroquinolones, including LEVAQUIN, have been associated with serious adverse reactions, reserve LEVAQUIN for use in patients who have no alternative treatment options for the following indications:


    • Uncomplicated urinary tract infection (1.12)
    • Acute bacterial exacerbation of chronic bronchitis (1.13)
    • Acute bacterial sinusitis"
Sounds dramatic to me. Also sounds pretty much like what the patient was trying to say. Anyway I'm sure you're going to defend your thread to the end and some people here might support it, but I mean, when the package insert agrees with the patient and you still call the patient out, that goes too far for me and I'm known for being a bigtime prick on these boards.
 
I see your point, and there are different ways to view this situation. I think that @cellsaver summed it up nicely below. And, as I'm sure you are aware, many drugs have package inserts that sound equally ominous (if not more so) so it isn't very impressive to just copy and paste those. I have to believe that this is a risk management situation. The likelihood of tendon rupture is quite rare (0.14-0.4% in general population, higher in patients with comorbidities). I guess at the end of the day, I'm just not impressed. Extravasated amio can eat flesh, daptomycin kills kidneys, and and young otherwise healthy people on levaquin VERY RARELY rupture tendons. It doesn't mean that they shouldn't be used. I'll agree to disagree. This isn't flame-war material.

The tendonitis and peripheral neuropathy can be disabling. It's not just tendon rupture... Neither the blog or the package insert do not suggest the antibiotic should never be used. Use all other alternatives because the concerns brought up are real and can be extremely severe and would suck when used for an uncomplicated UTI and **** like that.
 
The tendonitis and peripheral neuropathy can be disabling. It's not just tendon rupture... Neither the blog or the package insert do not suggest the antibiotic should never be used. Use all other alternatives because the concerns brought up are real and can be extremely severe and would suck when used for an uncomplicated UTI and **** like that.

I agree with you. If there is a low-risk alternative, it would only make sense to use that first. Originally it was the tone of the blog post and the lack of basic science knowledge that really "ground my gears". I mean, "DNA mitochondrial repair cells"?? To be fair though, I don't care for most mommy bloggers.
 
Also, you said that she didn't use buzzwords......the title of the post is "This antibiotic will ruin you". hmmmmmm notice the "will" instead of "could"? Drama if I've ever seen it.
 
I agree with you. If there is a low-risk alternative, it would only make sense to use that first. Originally it was the tone of the blog post and the lack of basic science knowledge that really "ground my gears". I mean, "DNA mitochondrial repair cells"?? To be fair though, I don't care for most mommy bloggers.
I think the theoretical mechanism for the neuropathy is some sort of mitochondrial toxicity that I've read somewhere - probably where she got it from, but is beyond my understanding. It did sound silly af.
 
I agree with you. If there is a low-risk alternative, it would only make sense to use that first. Originally it was the tone of the blog post and the lack of basic science knowledge that really "ground my gears". I mean, "DNA mitochondrial repair cells"?? To be fair though, I don't care for most mommy bloggers.
HI, "Mommy blogger" here, I guess. I am a mommy and a blogger so I guess that about sums it up. I wrote this post at 11pm at night on March 18th because I am constantly asked to share this information by people that I know personally. When I wrote it, I had 8 subscribers total. I was sharing what I believe to be the truth to the best of my knowledge. I don't sound "scientisty," because I am not one. I was half way through nursing school when I stopped because I became a mommy. The knowledge I have, is what I have gathered over 7 years of trying to learn as much about Fluoroquinolone antibiotics as I could, for the sake of my own health. I have talked to numerous doctors and surgeons and some of them have a large knowledge about this subject, and some sound strikingly similar to the tone I glean from your comments. I understand why you would think this way. I'm not a doctor, and I'm not a scientist and my blog is not perfect. I would hope that you could see past that to the abundance of rescourses I have shared, who are doctor and scientist based. I'm not anti vaccine or medical. I have a great deal of respect for about 85% of the medical community, especially those who are aware of the profession they work in. They practice medicine...practice. My doctor is a regular family medicine doc who works for a hospital network. She has asked for the same resources I've shared here, and through conversations, she explains things better to me, such as "DNA mitochondrial repair cells," being mitochondrial DNA, and I have been able to share the NCBI studies with her, proving that it actually isn't rare damage. This article that sounds "silly" talking about mitochondria, may help it not sound so "silly." Delayed cytotoxicity and cleavage of mitochondrial DNA in ciprofloxacin-treated mammalian cells. - PubMed - NCBI . I'm going to guess that you haven't read through the links I provided. Please read them, even if you see me an just an irritating "mommy blogger," who wrote an imperfect blog post late at night so I could share the information to my friends and family. I never dreamed we would be at 8.1 million views today. If you really want to correct me, help me learn about where my lingo is incorrect, and if the scientific studies are read incorrectly. To do that, you'd really have to research this, and I hope you will, because I want to write the truth. I won't be able to write an emotionless article about this subject, because it forever changed my life and who I am as a person. I can't run, jump, lift a toddler nephew, ride amusement park rides with my kids or squat. That will always bring emotion to the surface for me. It changed my whole life. As for proving this was the cause of my physical breakdown, I actually do have doctors notes where it is noted and it's in my health record. It took about 6 surgeons, numerous specialists, and tests ruling everything else out, to figure out the cause. Here is a note if you would like to see it. I do have the note where it was prescribed by her, but for her privacy I cannot upload it, because it would identify her.
 

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Also, you said that she didn't use buzzwords......the title of the post is "This antibiotic will ruin you". hmmmmmm notice the "will" instead of "could"? Drama if I've ever seen it.
Will is exactly what I meant. It damages the cells in all of the samples they tested. You can read that here Fluoroquinolones cause changes in extracellular matrix, signalling proteins, metalloproteinases and caspase-3 in cultured human tendon cells. - PubMed - NCBI . Each person's threshold is different. Some people notice the damage after 1 pill and some don't notice the damage after 25 courses.
 
Hello Mrs. Moser,

Congratulations on writing a book, having it published and one that appears to be selling. Kudos to you ! Many of us writers on these boards dream of having a book published so you have beat us to the punch. Good for you. The foto of you and your family on Amazon is beautiful. You look like a lovely woman, you have a very handsome husband and your children look adorable. You are very rich and blessed.

I apologize for the nasty comments some have written about you. The internet, as you know as a blogger, lowers peoples inhibitions and show the ugly side of the human potential. Our current culture is very dark precisely because people have lost any sense of self-regulation.

It would help if you rewrote your blog and corrected some errors. I write this charitably: it has many grammatical mistakes, poor attribution and your emotions run high from start to finish of the article which detract from your objective critique of FQs. These minimize your hopeful message which is why, in part, you have received the arrows others have sent your way on SDN

Additionally you never stated how you know that FQs caused your medical problems. You never stated that physicians told you the blame lies with FQs. As a nursing student you know that other factors may be involved (i.e. polypharmacy, Cytochrome P450, enzyme deficiencies, rapid/slow metabolizers, etc). FQs do in fact result in rare complications. Aspirin has been on the market for even more decades and that too causes complications. Removing Aspirin and FQs from the market would be a dis-service to the global community. It would be helpful if you provided documentation from your physicians that state clearly your medical problems are a result of FQs, e.g. pathology reports, laboratory records, medical letters (personal info redacted), etc.

You are right with regard to FQs being over-used. I had a career in the biotech industry and interfered with thousands of physicians in the clinical setting. Physicians are creatures of habit, much like everyone else. Historically FQs have been written empirically by physicians for many infectious settings because they provide broad coverage. Empiric treatment is important. It is also important to switch the ABX from the "big gun" to a narrower spectrum ABX once the physician receives the microbiology report that demonstrates the bug. It is important to use the appropriate ABX for the causative pathogen and not use a "big gun" for everything.

In the early 2000s FQs became a "one size fits all" for community based physicians (vs hospital based physicians). Community physicians are often criticized by Infectious Disease Specialists for contributing to ABX resistance because of their abusing them empirically and not switching ABX once they learned of the microbiology report results. I used to sponsor lectures on antibiotic resistance trends in hospitals in my region of the country, using the Antibiograms of each individual institutional setting. I would acquire the last 5 Antibiograms from the microbiologists at the major hospitals in my region, and deliver presentations or sponsor recognized experts in their fields, to physicians in their hospitals based on their hospital antibiograms reflecting the resistance trends for the last 5 years. The Microbiologist and Chief Clinical Pharmacist partnered with me to educate physicians on which Abx were most efficacious for each organism (e.g. Strep. pneumo, E. coli, Pseudomonas, etc) and which were failing in their setting. Sadly most physicians at the time in hospitals did not refer to their Antbiogram which were provided by the Microbiologist year after year for free. FQs was one of those Abx that exhibited resistance with E. coli (e.g. UTI) because physicians were overusing them in the community. Not too far behind FQs showing resistance trends during those years were Macrolides (e.g. Zithromax/Azithromycin and Biaxin/Clarithromycin). There was a time when "Z-pack" was practically a household name. It was the number 1 Abx used in America for one year thanks to Community based physicians. So yes, FQs are "big guns" and were over-used at one time. Likewise with other ABX classes.

Drugs come and go. There was a time I was delivering non-stop lectures to ER physicians, Hospitalists, Intensivists and hospital based physicians on IV/IM ABX with regard to QTc prolongation, hyperglycemia, hypoglycemia and various other AEs. Macrolides were presenting with QTc prolongation in my region of the country at the time. Additionally Macrolides and Statins show a higher likelihood of muscle injury (Rhabdomyolysis) when used together in some people. One of the major local hospitals had a death in the hospital allegedly because of a FQ that is no longer available on the market: Tequin (Gatifloxacin) marketed by Bristol Myers Squibb. That event caused panic in that institution and soon word spread about the dangers of Tequin. BMS was salivating at the time at the prospect of taking market share away from Cipro and Levaquin with Tequin. Medicine is a business. However, in time the FDA sent one of their infamous "Dear Doctor letters" on the dangers of Tequin and BMS quietly removed their once lauded FQ from the market because of hyperglycemia and hypoglycemia. That was a nail in the coffin to BMS because their pipeline was dry and they had lost patent exclusivity to many of their drugs (e.g. Pravachol, Zocor, Taxol, etc). Tequin had many hopes but its removal from the market showcased the problems with the class of FQs in some people.

In the case of Cipro, Levaquin, Avelox, they have served the global health population well just like Aspirin. Side effects happen with all medications. If you want to reach a wider market in your messaging about the dangers of FQs, I would suggest reviewing your blog, and consider making some of the corrections I mentioned earlier. Perhaps, with proper messaging, you can publish another book. Why not? There's an audience for every message.

Again, congratulations on publishing a book. Your family looks lovely and I pray God blesses you and your family a hundredfold. Pray for physicians and physicians in training. You have passion and that is a gift. May we all be as passionate about medicine and doing our homework.

Blessings
In one of my replies below, I do publish the note my doctor wrote as an attachment. It took 9 months to diagnose me. I had biopsies, saw 3 rheumatologists to rule out Rheumatologic conditions, genetic diseases, and rare cancer. I had ruptured 6 joints by the time my achilles tore. Over the time we didn't know what was wrong, my doctor kept asking me if I'd ever taken Levaquin. I had no idea what that was, so I told her no each time. After the achilles tore, she asked me again for the 4th time since the onset of this ordeal. It prompted me to go home and type Levaquin into google. A whole bunch of info came up about tendon rupture and the Fluoroquinolone family of antibiotics. I saw Cipro listed there and remembered she had prescribed that for me not long before I fell apart. I printed the FDA warning that existed in 2011 and brought it to her. She was horrified. She gasped and covered her mouth and said, "I thought it was only Levaquin that could do this, I had no idea it was the whole family of antibiotics." She then pulled up my chart and confirmed she had prescribed it for my UTI 2 weeks before the first spontaneous joint injury. I went and consulted a lawyer in hopes to go after the drug companies for not having adequate warnings out there. I took it in 2010 before the updated warnings were issued. The lawyers bounced it around to 5 law firms, each way bigger than the last. They finally said they would help me sue my doctor for malpractice but the drug companies are pretty protected because they did have warnings out, they just expected the physicians to seek them out and when they don't it leave them open for lawsuit. My doctor never meant to hurt me and I knew that. Ethically I couldn't do that to her. I am not even advocating for taking these antibiotics off the market, only that they be prescribed as a last resort like the FDA warning indicates. They say themselves that in uncomplicated infection, the benefits, do not outweigh the risks. I do tell the unfolding of this story in my book. I very much appreciate your input here. Thank you on your compliments to my family as well. They have been the driving force behind my belief that I have been very blessed in spite of trials.
 
This quote about sums it up (in reference to fluoroquinolones)

"they actually damage the DNA mitochondrial repair cells."

Much like the rest of the article, this statement is sort of almost accurate, but is really just a lot of out of context medical Mumbo jumbo being explained by someone with an axe to grind and no understanding of medicine.
Sorry I couldn't get to this sooner. I was grinding an axe. Please, if nothing else, go read the information I linked to my article. Even if you don't believe my "mumbo jumbo," there is a whole lot of rescourses behind what I'm trying to explain with "no understanding of medicine."
 
Tendon ruptures are a well known albeit rare complication of fluoroquinolones.

Often with these blogs, there is more to the story. None of us know her medical history. She may very well have something else and has chosen to blame the medication.
See below, I do reply with an attachment.
 
Will is exactly what I meant. It damages the cells in all of the samples they tested. You can read that here Fluoroquinolones cause changes in extracellular matrix, signalling proteins, metalloproteinases and caspase-3 in cultured human tendon cells. - PubMed - NCBI . Each person's threshold is different. Some people notice the damage after 1 pill and some don't notice the damage after 25 courses.
Millions of people take these every day and aren't "ruined". Your 8.1 million views are just the result of a clever clickbait title, not because you are providing quality info.
 
Millions of people take these every day and aren't "ruined". Your 8.1 million views are just the result of a clever clickbait title, not because you are providing quality info.
Can you actually disprove me or are you just satisfied to criticize my title? For the sake of your future patients, I hope that you will get past your personal feelings about who you perceive that I am, and do some actual research.
 
Sorry I couldn't get to this sooner. I was grinding an axe. Please, if nothing else, go read the information I linked to my article. Even if you don't believe my "mumbo jumbo," there is a whole lot of rescourses behind what I'm trying to explain with "no understanding of medicine."

First thank you for coming here to respond to us in person. You're defending your point respectfully and that's something we could use more of around here.


The major issue I have with your article is that most of the people who read it aren't scientists. They don't walk away from it thinking

"I am not even advocating for taking these antibiotics off the market, only that they be prescribed as a last resort like the FDA warning indicates"

As you said, instead they think "all antibiotics are bad and should never be used, and I shouldn't trust any doctor who prescribes them".

My mom was this way. She sends me a post a week, including yours a while back. When we were kids she didn't vaccinate us and my little brother nearly died. We both grew up having months long sinus infections that she refused to treat with simple antibiotics. I have ulcerative colitis and she withheld treatment from me until I was 18 and I went out and got the drugs on my own. Her answer was to take herbs she read about on line.

I don't doubt that you had an aweful experience with this drug. But the way you write your article causes major distrust in the lay public about huge swaths of the healthcare system. One person may read your article and not take an FQ, and save themselves from an adverse reaction. But there are many more who will withhold treatment from their kids, elders, etc. who could die as a result. Thanks again for reading,

Knife
 
Can you actually disprove me or are you just satisfied to criticize my title? For the sake of your future patients, I hope that you will get past your personal feelings about who you perceive that I am, and do some actual research.
Sure, I'll throw some numbers around. And I agree with you, the studies do show some detrimental changes in the body due to FQ abx use. BUT the point here is that very few have the severe symptoms that you experienced. It's terrible that you had to go through that, but the reality is that 0.14-0.4% of the general public is at risk for having a reaction like you did. That's a pretty low rate of occurrence. The title is sort of hard for me to get past. In both the title and the article, you sort of imply that EVERYONE will experience detrimental reactions to these drugs by saying "This antibiotic will ruin you".That is misleading, since so many people use FQ without noticeable effects. I was just asking a family physician I work with about FQ the other day, and in 15 years of practice he has never seen a problem like this (don't take this as gospel though, because it is anecdotal and I hate anecdotal evidence.)

Like I said before, this comes down to risk management. These drugs shouldn't be used as a first choice if there are alternatives, sure. I guess I'm a tad confused on what goal you are trying to accomplish by writing this. Nobody is saying that they can't cause damage or that they don't "cause changes in every sample of tissue". It's just that noticeable complications are so rare that it doesn't make sense to ban their use.
 
Sure, I'll throw some numbers around. And I agree with you, the studies do show some detrimental changes in the body due to FQ abx use. BUT the point here is that very few have the severe symptoms that you experienced. It's terrible that you had to go through that, but the reality is that 0.14-0.4% of the general public is at risk for having a reaction like you did. That's a pretty low rate of occurrence. The title is sort of hard for me to get past. In both the title and the article, you sort of imply that EVERYONE will experience detrimental reactions to these drugs by saying "This antibiotic will ruin you".That is misleading, since so many people use FQ without noticeable effects. I was just asking a family physician I work with about FQ the other day, and in 15 years of practice he has never seen a problem like this (don't take this as gospel though, because it is anecdotal and I hate anecdotal evidence.)

Like I said before, this comes down to risk management. These drugs shouldn't be used as a first choice if there are alternatives, sure. I guess I'm a tad confused on what goal you are trying to accomplish by writing this. Nobody is saying that they can't cause damage or that they don't "cause changes in every sample of tissue". It's just that noticeable complications are so rare that it doesn't make sense to ban their use.
Ok after reading your previous posts, I can see that you are just advocating for last-resort use. That sounds good to me. Most docs I work with won't prescribe them as first-line treatment. I wish you would have made that a little more clear and left out the drama in your post. More people in the medical community would've listened. Emotional spouting is an instant turn off.
 
I am not even advocating for taking these antibiotics off the market, only that they be prescribed as a last resort like the FDA warning indicates.

last resort as of 2016? perhaps if no other treatment option is available.
5, 10, 15 years ago? no.

July 26, 2016:
FDA Drug Safety Communication: FDA updates warnings for oral and injectable fluoroquinolone antibiotics due to disabling side effects

Health care professionals should not prescribe systemic fluoroquinolones to patients who have other treatment options for acute bacterial sinusitis (ABS), acute bacterial exacerbation of chronic bronchitis (ABECB), and uncomplicated urinary tract infections (UTI) because the risks outweigh the benefits in these patients. Stop fluoroquinolone treatment immediately if a patient reports serious side effects, and switch to a non-fluoroquinolone antibacterial drug to complete the patient’s treatment course

I am glad you did not sue your physician. As you already stated, she had no malice nor intentions in harming you. She was just trying to help you re: your medical problems. She chose an ABX that has been proven to be efficacious and safe for the majority of the population. Adverse events exist in all drugs. You may be just part of that very rare population that FQs might be contraindicated. I see a book here. 🙂
 
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Sure, I'll throw some numbers around. And I agree with you, the studies do show some detrimental changes in the body due to FQ abx use. BUT the point here is that very few have the severe symptoms that you experienced. It's terrible that you had to go through that, but the reality is that 0.14-0.4% of the general public is at risk for having a reaction like you did. That's a pretty low rate of occurrence. The title is sort of hard for me to get past. In both the title and the article, you sort of imply that EVERYONE will experience detrimental reactions to these drugs by saying "This antibiotic will ruin you".That is misleading, since so many people use FQ without noticeable effects. I was just asking a family physician I work with about FQ the other day, and in 15 years of practice he has never seen a problem like this (don't take this as gospel though, because it is anecdotal and I hate anecdotal evidence.)

Like I said before, this comes down to risk management. These drugs shouldn't be used as a first choice if there are alternatives, sure. I guess I'm a tad confused on what goal you are trying to accomplish by writing this. Nobody is saying that they can't cause damage or that they don't "cause changes in every sample of tissue". It's just that noticeable complications are so rare that it doesn't make sense to ban their use.
Why do you keep saying "ban their use?" I have never advocated for that. I am and have been advocating that patients be aware of these side effects and have a conversation with their doctor to ask for alternatives if it is not a last resort situation. You call this anecdotal evidence, but the incidence has been enough for the FDA to update their warnings numerous times in the last several years. They obviously think it's a problem and are informing doctors as well as patients in the warning. Why do you have an issue with this? The chances of it happening to me is apparently 100%, because it absolutely did. I would never want another person to go through this if it wasn't the only choice they had left. Informing patients and doctors has and continues to be my goal. I have had great feedback by medical professionals, including the ones who treat me. I get emails and blog comments every day, either from patients this has happened to, or doctors asking for more information. This information is helping, at least the ones willing to dig deeper.
 
last resort as of 2016? perhaps if no other treatment option is available.
5, 10, 15 years ago? no.

July 26, 2016:
FDA Drug Safety Communication: FDA updates warnings for oral and injectable fluoroquinolone antibiotics due to disabling side effects

Health care professionals should not prescribe systemic fluoroquinolones to patients who have other treatment options for acute bacterial sinusitis (ABS), acute bacterial exacerbation of chronic bronchitis (ABECB), and uncomplicated urinary tract infections (UTI) because the risks outweigh the benefits in these patients. Stop fluoroquinolone treatment immediately if a patient reports serious side effects, and switch to a non-fluoroquinolone antibacterial drug to complete the patient’s treatment course

I am glad you did not sue your physician. As you already stated, she had no malice nor intentions in harming you. She was just trying to help you re: your medical problems. She chose an ABX that has been proven to be efficacious and safe for the majority of the population. Adverse events exist in all drugs. You may be just part of that very rare population that FQs might be contraindicated. I see a book here. 🙂
I actually did write a book 🙂 It's called "The Magnificent Story of a Lame Author." I wish this was as rare as it sounds, but it's becoming more and more common. My book mentions the cause of my physical problems and how I came to know it was that with my doctors help, but the story is very much about how my family and I dealt with a huge life change and stayed thankful for the blessings still through out the struggle. I actually am on the radio today.
 
Ok after reading your previous posts, I can see that you are just advocating for last-resort use. That sounds good to me. Most docs I work with won't prescribe them as first-line treatment. I wish you would have made that a little more clear and left out the drama in your post. More people in the medical community would've listened. Emotional spouting is an instant turn off.
I actually don't think I could write or even speak about this topic without drama. The changes it implemented in my life felt very dramatic, as does the underlying desire in my heart, to not see this happen to other people. I wasn't trying to write the blog post for medical professionals or even strangers. I wrote this for friends and family who ask questions all the time, and to give them the info they might want to share it with their friends and family. I guess it worked, because it spread. It must have also caught a medical professional's eye, because Dr. Bonati from the Bonati Spine Institute interviewed me on the radio for The Health and Wellness show. I very much appreciate that you read my blog closely enough to know what I am advocating for. Thank you for also responding respectfully. I appreciate that.
 
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