When Prescribed Incorrectly, Lifesaving Antibiotics Can Be Dangerous, Carry Real Risks

August 17, 2018 by CDC's Safe Healthcare Blog

Rachel Brummert, B.S., M.S., President of Patient Safety Impact

In 2006, my doctor prescribed me Levaquin—a fluoroquinolone antibiotic—for a suspected sinus infection. A few weeks later, I ruptured my Achilles tendon while walking across a parking lot to my car.

Since that time, I have suffered 24 tendon ruptures, each of which required extensive reconstructive surgeries. In addition, I suffer from central and autonomic nervous system damage. This damage is permanent. I also have short-term and long-term memory loss, loss of balance, peripheral neuropathy in my extremities, chronic pain, chronic low blood pressure, and other symptoms that make daily life challenging.

I never knew that an antibiotic, which I thought was supposed to help me feel better, could cause an otherwise healthy person like myself to become disabled at 36 years old.

It is important that both patients and healthcare providers are aware of both the risks and benefits of fluoroquinolones and make an informed decision about their use.

The most commonly prescribed fluoroquinolones are Levaquin (levofloxacin), Cipro (ciprofloxacin), and Avelox (moxifloxacin). Per the Food and Drug Administration (FDA), prescribing fluoroquinolones for acute bacterial sinus infections, acute bacterial exacerbation of chronic bronchitis, or uncomplicated urinary tract infections can put a patient at risk for severe, disabling, and often permanent adverse reactions. For those infections, the risks outweigh the benefits. That is exactly what happened to me.

Unfortunately, my story is not rare. Many victims have suffered adverse events after being unnecessarily prescribed a fluoroquinolone antibiotic.

In November 2015, the FDA held an Advisory Committee Hearing about the risks versus benefits of fluoroquinolones, at which I testified, and the panel concluded that the serious risks associated with the use of fluoroquinolones for these types of uncomplicated infections generally outweighed the benefits for patients with other treatment options. Based on Advisory Committee recommendations, the FDA issued a limitations-of-use directive on July 26, 2016.

Despite several FDA Black Box warnings on fluoroquinolones, they are still commonly prescribed because these warnings are not reaching their intended audiences—healthcare providers and patients. Guidelines recommend alternatives to fluoroquinolone antibiotics to treat minor, uncomplicated infections.

What happened to me, and many others, can be prevented. Had we known that the risks of fluoroquinolones outweigh the benefits for some infections, we would have discussed alternative treatment recommendations with our doctors. Educating healthcare providers and patients about improving antibiotic prescribing and use and raising awareness about the risks of fluoroquinolones will help reduce the likelihood that others suffer the same fate.

Read more about how fluoroquinolones are prescribed in doctor’s offices and emergency departments. Ask your healthcare provider if the antibiotic he or she is prescribing is the right tool to treat your illness.