[Posted 12/20/2018]AUDIENCE: Health Professional, Infectious Disease, Cardiology, Patient ISSUE: FDA review found that fluoroquinolone antibiotics can increase the occurrence of rare but serious events of ruptures or tears in the main artery of the body, called the aorta. These tears, called aortic dissections, or ruptures of an aortic aneurysm can lead to dangerous bleeding or even death. They can occur with fluoroquinolones for systemic use given by mouth or through an injection. BACKGROUND: Fluoroquinolone antibiotics are approved to treat certain bacterial infections and have been used for more than 30 years. They work by killing or stopping the growth of bacteria that can cause illness. Without treatment, some infections can spread and lead to serious health problems (see List of Currently Available FDA-Approved Systemic Fluoroquinolones, available at RECOMMENDATION: Healthcare professionals should: Taking ciprofloxacin increases the risk that you will develop tendinitis (swelling of a fibrous tissue that connects a bone to a muscle) or have a tendon rupture (tearing of a fibrous tissue that connects a bone to a muscle) during your treatment or for up to several months afterward. This includes bone and joint infections, intra abdominal infections, certain type of infectious diarrhea, respiratory tract infections, skin infections, typhoid fever, and urinary tract infections, among others. Ciprofloxacin is used to treat a wide variety of infections, including infections of bones and joints, endocarditis, gastroenteritis, malignant otitis externa, respiratory tract infections, cellulitis, urinary tract infections, prostatitis, anthrax, and chancroid. Ciprofloxacin only treats bacterial infections; it does not treat viral infections such as the common cold. For certain uses including acute sinusitis, lower respiratory tract infections and uncomplicated gonorrhea, ciprofloxacin is not considered a first-line agent. Ciprofloxacin occupies an important role in treatment guidelines issued by major medical societies for the treatment of serious infections, especially those likely to be caused by Gram-negative bacteria, including Pseudomonas aeruginosa. For example, ciprofloxacin in combination with metronidazole is one of several first-line antibiotic regimens recommended by the Infectious Diseases Society of America for the treatment of community-acquired abdominal infections in adults. In other cases, treatment guidelines are more restrictive, recommending in most cases that older, narrower-spectrum drugs be used as first-line therapy for less severe infections to minimize fluoroquinolone-resistance development.
Quinolone antibiotics (including ciprofloxacin) may cause serious and possibly permanent tendon damage (such as tendonitis, tendon rupture), nerve problems in the arms and legs (peripheral neuropathy), and nervous system problems. Get medical help right away if you have any of the following symptoms: pain/numbness/burning/tingling/weakness in your arms/hands/legs/feet, changes in how you sense touch/pain/temperature/vibration/body position, severe/lasting headache, vision changes, shaking (tremors), seizures, mental/mood changes (such as agitation, anxiety, confusion, hallucinations, depression, rare thoughts of suicide). Tendon damage may occur during or after treatment with this medication. Stop exercising, rest, and get medical help right away if you develop joint/muscle/tendon pain or swelling. Your risk for tendon problems is greater if you are over 60 years of age, if you are taking corticosteroids (such as prednisone), or if you have a kidney, heart, or lung transplant. This medication may make a certain muscle condition (myasthenia gravis) worse. Tell your doctor right away if you have new or worsening muscle weakness (such as drooping eyelids, unsteady walk) or trouble breathing. Ciprofloxacin is a fluoroquinolone (flor-o-KWIN-o-lone) antibiotic that fights bacteria in the body. It is used to treat different types of bacterial infections, including skin infections, bone and joint infections, respiratory or sinus infections, urinary tract infections, and certain types of diarrhea. Ciprofloxacin is also used to treat people who have been exposed to anthrax or certain types of plague. Ciprofloxacin should be used only for infections that cannot be treated with a safer antibiotic. Fluoroquinolone antibiotics can cause serious or disabling side effects that may not be reversible, such as tendon rupture or nerve problems. Ciprofloxacin can cause serious side effects, including tendon problems, nerve damage, serious mood or behavior changes, or low blood sugar. Stop using this medicine and call your doctor at once if you have symptoms such as: headache, hunger, irritability, numbness, tingling, burning pain, confusion, agitation, paranoia, problems with memory or concentration, thoughts of suicide, or sudden pain or movement problems in any of your joints. In rare cases, ciprofloxacin may cause damage to your aorta, which could lead to dangerous bleeding or death.
Commonly reported side effects of ciprofloxacin include: pyelonephritis, arthralgia, and musculoskeletal signs and symptoms. See below for a comprehensive list of adverse effects. Applies to ciprofloxacin: oral powder for suspension, oral tablet Other dosage forms: Along with its needed effects, ciprofloxacin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur while taking ciprofloxacin: Some side effects of ciprofloxacin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Applies to ciprofloxacin: intravenous solution, oral powder for reconstitution, oral tablet, oral tablet extended release The most common side effects (from clinical trials of all formulations, doses, durations of therapy, and indications) were nausea, diarrhea, abnormal liver function tests, vomiting, and rash. A study investigated the effect of ciprofloxacin on mitochondria, the important cell organelles in our body that produce the energy for cellular function. Ciprofloxacin stopped normal maintenance and transcription of mitochondrial DNA by changing mt DNA topology, causing impaired mitochondrial energy production and blocking cellular growth and differentiation. Antibiotics have saved many lives by rescuing patients with bacterial or fungal infections, but these valuable drugs also have a dark side. As most medical drugs, also many antibiotics can have undesired effects on the body's metabolism, causing more or less severe symptoms. The group of fluoroquinolones with its most famous member ciprofloxacin is such a case: Fluoroquinolones are some of the most frequently used broad-spectrum antibacterial antibiotics, and usually prescribed for respiratory, urinary or ear infections. While they are generally well tolerated, some patients receiving fluoroquinolones develop severe health problems, among them tendon rupture, permanent nerve damage or depression. The reasons for these side effects are yet unclear.
How to take ciprofloxacin. Before you start taking ciprofloxacin, read the manufacturer's printed information leaflet from inside the pack. The manufacturer's leaflet will give you more information about the medicine and a full list of the side-effects which you may experience from taking it. Side Effects. Drug information provided by IBM Micromedex Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.