Fluoroquinolones are antimicrobials, medications used to treat infections caused by microorganisms. Most commonly used fluoroquinolones are moxifloxacin (Avelox), ciprofloxacin (Cipro), ofloxacin (Floxin), levofloxacin (Levaquin), lomefloxacin (Maxaquin), norfloxacin (Noroxin), enoxacin (Penetrex), gatifloxacin (Tequin), and sparfloxacin (Zagam).
The fluoroquinolones as a class are generally well tolerated. Most side effects are mild in severity, self-limited, and rarely result in treatment discontinuation. However, some people have had severe and life-threatening reactions to fluoroquinolones. Some side effects are so strange, that people often don't associate them with the drug. It's unclear why some people react to medication while others do not.
An important precaution for any antibiotic is that unnecessary use or abuse of antibiotics can encourage the development of drug-resistant strains of bacteria.
Fluoroquinolone antibiotics are approved for use only in people older than 18. Research suggests that this class of medicines may cause bone development problems in children and teenagers. Infants, children, teenagers, pregnant women, and women who are breastfeeding should not take this medicine unless directed to do so by a physician.
Gastrointestinal effects. The most common side effects with fluoroquinolones are nausea, vomiting, diarrhea, constipation, and abdominal pain, which occur in 1 to 5% of patients.
Central Nervous System effects. These medicines make some people feel drowsy, dizzy, lightheaded, or less alert. Insomnia occurs in 3-7% of patients who take ofloxacin. These drugs can quickly concentrate in the brain and interfere with a receptor that normally prevents seizures. Although seizures are very rare, fluoroquinolones should be avoided in patients with a history of convulsion, cerebral trauma, or anoxia. No seizures have been reported with levofloxacin, moxifloxacin, gatifloxacin, and gemifloxacin.
Phototoxicity. These antibiotics may increase sensitivity to sunlight. Even brief exposure to sun can cause severe sunburn or a rash. While being treated with fluoroquinolones, avoid being in direct sunlight, especially between 10 a. m. and 3 p. m. ; wear a hat and tightly woven clothing that covers the arms and legs; use a sunscreen with a skin protection factor (SPF) of at least 15; protect the lips with a sun block lipstick; and do not use tanning beds, tanning booths, or sunlamps. The degree of phototoxic potential of fluoroquinolones is as follows: lomefloxacin > sparfloxacin > ciprofloxacin > norfloxacin = ofloxacin = levofloxacin = gatifloxacin = moxifloxacin.
Tendon damage (tendonitis and tendon rupture). Some fluoroquinolones may weaken the tendons in the shoulder, hand, or heel, making the tendons more likely to tear. Anyone who notices pain or inflammation in these or other tendon areas should stop taking the medicine immediately and call a physician. Rest and avoid exercise until the physician determines whether the tendons are damaged. If the tendons are torn, surgery may be necessary to repair them. Potential risk factors for tendon damage include age >50 years, male gender, and concomitant use of corticosteroids.
Cardiovascular effects. The newer quinolones have been found to produce additional toxicities to the heart that were not found with the older compounds. Evidence suggests that sparfloxacin and grepafloxacin may have the most cardiotoxic potential.
Hypoglycemia/Hyperglycemia. Recently, rare cases of hypoglycemia have been reported with gatifloxacin and ciprofloxacin in patients also receiving oral diabetic medications, primarily sulfonylureas. Although hypoglycemia has been reported with other fluoroquinolones (levofloxacin and moxifloxacin), the effects have been mild.
Hypersensitivity. Hypersensitivity reactions occur only occasionally during quinolone therapy and are generally mild to moderate in severity, and usually resolve after treatment is stopped.
Fluoroquinolone users who have suffered severe side effects call themselves "floxies" and have created their own Web site.
Traveler's Diarrhea - Do I Need Antibiotics?
This is a controversial issue. Many international travelers pack some Cipro or another antibiotic in case Montezuma's revenge strikes them with a fury. Are antibiotics the right choice for traveler's diarrhea? Is there a risk? What else can travelers do?
Traveler's diarrhea can develop abruptly and can limit your sightseeing to your hotel room toilet. This unlucky event occurs when a traveler ingests bacteria, or less likely a virus, from contaminated food or drink, or from hand to mouth contact. About half of all travelers to the developing world will develop this condition. While it is an unfortunate event, it does have a health benefit as these folks receive an aerobic workout as they sprint towards rest rooms several time a day.
If traveler's diarrhea occurs, travelers can experience relief with Imodium, Pepto Bismol and prayer. Some physicians advise beginning antibiotics instead as even a single dose can shorten the illness. This strategy makes particular sense for travelers who are on a short trip. However, if the stools are bloody or the traveler has a fever, then you should consult with a physician right away as this may not be a simple case of traveler's diarrhea.
Why shouldn't every traveler who is starting to spurt and squirt just reach for some Cipro? The overuse of antibiotics has many serious side-effects. Beyond the expense, excessive antibiotic use breeds resistant germs which can become immune to currently available antibiotics. If Cipro or other antibiotics are taken automatically for traveler's diarrhea, then the new & improved germs that may emerge may cause diarrhea and other illnesses that can't be easily treated. In addition, antibiotics can cause a serious colon infection called C. difficile colitis (known as C. diff), which can be a serious and permanent illness that can change your life. I am a gastroenterologist and have seen patients who became miserable with this condition after only one or two antibiotic pills.
International travelers have many strategies to prevent traveler's diarrhea. Review these precautions with your travel doctor before departure. Be cautious and be prepared. Bring imodium and antibiotics, just in case. You might want to pack your running shoes also. Hopefully, you'll only need them to take afternoon jogs in the park.
The Best Ways to Cure Diverticulitis
Diverticulitis involves an inflammation and infection of pockets within the colon that have food stuffs or stool blocking the opening of the pocket. The disease comes out of having diverticulosis, which involves many such pockets in the colon, often due to constipation and a low fiber diet. Low fiber diets cause you to strain at the stool so that the pockets form because of the extra pressure in the colon. Diverticulitis and diverticulosis increase with age. It is necessary to cure diverticulitis when it occurs because failure to do so can lead to rupture of the diverticuli (pockets) and diffuse abdominal infection, which is often fatal if not promptly treated.
There are ways to cure diverticulitis at home using oral antispasmodics such as Bentyl (dicyclomine), Librax (chlordiazepoxide), Donnatol and Levsin (hyoscyamine). These keep the pain at bay by blocking the spasms of the lower colon. One can also use painkillers which tend to slow down the movement of the digestive tract and take care of the pain of the infection. Doctors also cure diverticulitis using strong antibiotics that kill the infection and return the diverticulum to its normal state. Such antibiotics include Cipro (ciprofloxacin), Flagyl (metronidazole), Keflex (cephalexin) and Vibramycin (doxycycline). These antibiotics can be given in oral form if you are staying at home and don't have a severe infection.
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