There has been a recent recirculation of information warning against the use of ciprofloxacin and other antibiotics of the fluoroquinolone class. The warnings are specific to the association these drugs have with disrupting the healthy function of connective tissue, potentially causing tendon rupture and retinal detachment. Inflammation of tendons (tendonitis) is also a risk factor of taking these drugs. A number of journals have published studies about these side effects, and the drugs have a black box warning.
Ciprofloxacin, a first line antibiotic for many types of infections
Ciprofloxacin has historically been used as a first line antibiotic for many types of infections, but has been recommended against in recent years. It is still sometimes used, however, and both patients and doctors should be aware of the risks involved in its use.
Tendon rupture, retinal detachment, and other connective tissue damage
In addition to tendon rupture and retinal detachment, other connective tissue types may be involved. A key tissue that is concerning is the aorta. Two retrospective studies have shown an association between fluoroquinolone use and cardiovascular complications. Patients having taken fluoroquinolones had an elevated risk for aneurysms and dissections than patients who had not taken these antibiotics.
Aneurysms result from the loss of integrity between the layers of tissue comprising the vessel wall, forming a balloon-like space in the vessel that weakens its integrity. Though connective tissue certainly plays a role in the integrity of vessels like the aorta, there are a lot of factors that play into the formation of an aneurysm.
Association between fluoroquinolone use and increased risk of aortic disease
To clarify the association between fluoroquinolone use and increased risk of aortic disease, researchers used a mouse model of human aortic aneurysms and dissections (ADD).
Findings were drastic
In mice with normal, unstressed aortas, treatment with ciprofloxacin showed no significant negative impact. However, in aortas with moderate stress, treated with cipro, 79 percent of the mice developed ADD – 67 percent had aortic dissections, and 15 percent had fatal ruptures. The findings were similar across males and females.
Results warn against the use of these medications
These results warn against the use of these medications in individuals who have questionable cardiovascular status, or are known to be at risk for vascular damage.
LeMaire SA, Zhang L, Luo W, et al. Effect of Ciprofloxacin on Susceptibility to Aortic Dissection and Rupture in Mice. JAMA Surg. Published online July 25, 2018. doi:10.1001/jamasurg.2018.1804
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Razi Berry is the founder and publisher of the journal, Naturopathic Doctor News & Review, that has been in print since 2005 and the premier consumer-faced website of naturopathic medicine, NaturalPath. She is the host of The Natural Cancer Prevention Summit and The Heart Revolution-Heal, Empower and Follow Your Heart, and the popular 10 week Sugar Free Summer program. From a near death experience as a young girl that healed her failing heart, to later overcoming infertility and Chronic Fatigue Syndrome and Fibromyalgia through naturopathic medicine, Razi has lived the mind/body healing paradigm. Her projects uniquely capture the tradition and philosophy of naturopathy: The healing power of nature, the vital life force in every living thing and the undeniable role that science and mind/body medicine have in creating health and overcoming dis-ease. Follow Razi on Facebook at Razi Berry and join us at Love is Medicine to explore the convergence of love and health.