Cipro a strong antibiotic that comes with risks
Mehmet Oz, M.D., is host of “The Dr. Oz Show,” and Mike Roizen, M.D., is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email questions to youdocsdaily@sharecare.com.
QUESTION: I had a urinary tract infection about a year ago and went to the emergency room to get treated.
They gave me Cipro, which cleared it up, but I had stomach problems afterward. Then I heard it’s toxic for the liver, nerves and the heart.
Why would they give this to you in the ER?
— Mary D., Tucson, Ariz.
ANSWER: If you find yourself in the emergency department with a respiratory or urinary tract infection, the first-line antibiotic that doctors or nurse practitioners probably will dispense is ciprofloxacin (Cipro). It’s the most popular antibiotic in the class of fluoroquinolones, and docs choose those in situations where they don’t know exactly what bacteria is causing the problem. They work because they’re broad spectrum, which means they can treat a whole range of infections.
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Unfortunately, they’ve been known to cause serious problems. Six years ago, the Food and Drug Administration warned fluoroquinolones may cause sudden, serious and potentially permanent nerve damage. Since then, they’ve also warned about tendon, muscle and joint damage. Add to that a National Institutes of Health warning of toxic liver damage if they’re taken for one to four weeks.
Now we have the latest FDA warning: This class of antibiotics can cause fatal heart damage in patients who have, “aortic aneurysm or are at risk for an aortic aneurysm.” That includes folks with peripheral atherosclerotic vascular diseases such as PAD (peripheral artery disease), high blood pressure, certain genetic conditions and the elderly. When you consider about 75 million American adults — about 1 in 3 — have high blood pressure, there are a lot of people at risk if they take antibiotics such as Cipro.
Our advice? If you’re presented with Cipro in the emergency room, ask about effective antibiotics that are not fluoroquinolones. You even could ask for a second opinion from an infectious disease specialist.
In some situations, the benefits of Cipro and its cousins far outweigh the risks; in others, you want to find an alternative.
Which options you have all depends on what kind of infection brought you to the ER.
