Re: The Fluoroquinolone Drugs are the most toxic and dangerous antibiotic in clinical practice today"Crystalluria is of no clinical significance. A huge number of people
have crystals in their urine for varying reasons who never go on to
develop kidney stones. You're trying to change the focus of the
discussion. This at no time involved "crystalluria" which is of no
importance." skeptic
The original discussion involved whether or not cipro was safe. Yet
you refuse to provide any citations regarding this original issue and
continue to harp on a secondary and rather unimportant aspect of
this. Kidney stones and bladder stones. Whether or not it caused
kidney stones was mentioned in passing due to you stating that cipro
did not. It does. You asked for a citation and I provided it.
Bladder stones was secondary to that discussion and was simply
mentioned in regards to the PH of urine. Of course you just blew that
warning off just like you have the rest of citations I provided you.
The fact that my original kidney stone was induced by Cipro seems to
have escaped your notice. A re-challenge nine months later produce
yet another stone. Both containing Cipro. Since that time, with no
further exposure to the quinolones I have been "stone free" for over
eight years now. The same as I was prior to being given Cipro, where
I was stone free for forty five years. By any scientific standards
that is reasonable "cause and effect" as there were no "underlying"
medical conditions that would cause such stone formations.
In the above statement you reveal your total and complete ignorance
regarding this whole affair. You seem to believe that crystalluria is
of no importance.
"In clinical practice, a crystalluria due to ciprofloxacin has been
recorded in patients [1], as well as in a patient who developed
obstructive uropathy due to massive ciprofloxacin crystal
precipitation in the distal ureters and bladder, after a 24-day
treatment at a dose of 500 mg twice daily [2]. In addition, a new case
with acute renal failure and ciprofloxacin crystalluria has recently
been published [3]. "
Citing to:
Ciprofloxacin crystalluria
Giovanni B. Fogazzi1,, Giuseppe Garigali1, Claudia Brambilla2 and
Michel Daudon3
1Research laboratory on urine of Unità Operativa di Nefrologia,
Fondazione IRCCS, Ospedale Maggiore Policlinico, Mangiagalli e Regina
Elena, 2Unità Operativa di Nefrologia Ospedale S. Paolo, Milano, Italy
and 3Service de Biochimie A, Hôpital Necker, Paris, France
* ndt.oxfordjournals.org/cgi/content/full/21/10/2982#B5
Yet you state that obstructive uropathy and renal failure due to cipro
induced crystalluria is of no "clinical significance" and "of no
importance." Neither is spontaneous tendon ruptures or peripheral
neuropathy I would then assume as well. I keep trying to end this
useless discussion and yet you keep on challenging and insulting me.
But I cannot allow you to post frivolous unsupported statements such
as that.
1. Boll P and Tillotson G. (1995) Tolerability of fluoroquinolone
antibiotics. Drug Safety 13:344-358.
2. Chopra N, Fine PL, Price B, et al. (2000) Bilateral hydronephrosis
from ciprofloxacin induced crystalluria and stone formation. J Urol
164:438.
3. Sedlacek M, Suriawinata AA, Schoolwert A, et al. (2006)
Ciprofloxacin crystal nephropathy - a 'new' cause of acute renal
failure [letter]. Nephrol Dial Transplant doi:10.1093/ndt/gfl160.
OK, let us talk about relativity, another attempt you made at changing
the course of the discussion:
oral cefixime or trimethoprim/sulfamethoxazole / IV ceftazidime; IV
ceftazidime followed by oral cefixime; and sequential IV ceftazidime
to oral trimethoprim/sulfamethoxazole
vs.
Cipro
Study 100169
Bottom line: Ciprofloxacin patients were more likely to report more
than one event and on more than one occasion compared to control
patients and arthropathy occurred more frequently in patients treated
with ciprofloxacin than control, regardless of whether they received
IV or oral drug.
Study 100169
This was a prospective, randomized, double-blind, active-controlled,
parallel group,
multinational, multicenter pediatric clinical trial. Patients from 1
year to < 17 years diagnosed with complicated urinary tract infection
(cUTI) or pyelonephritis were enrolled. Patients were stratified prior
to randomization based on whether, in the opinion of the clinical
investigator; intravenous (IV) therapy was initially warranted.
Patients were then randomized to receive either ciprofloxacin or
comparator antibiotics. In the first stratum, ciprofloxacin oral
suspension was compared to the comparator regimens of oral cefixime or
trimethoprim/sulfamethoxazole (TMP/SMX) [in Canada only]. In the
second stratum ciprofloxacin (IV or IV followed by oral suspension)
was compared to one of the following comparator regimens: IV
ceftazidime; IV ceftazidime followed by oral cefixime; and sequential
IV ceftazidime to oral TMP/SMX [in Canada only].
Arthropathy occurred more frequently in patients who received
ciprofloxacin than the
comparator and was defined as any condition affecting a joint or
periarticular tissue that may have been temporary or permanent
(including bursitis, inflammation of the muscular or tendinous
attachment to the bone, and tendonitis). The affected joints included:
knee, elbow, ankle, hip, wrist, and shoulder. Arthropathy, as shown in
Table 1, was seen in 9.3% (31/335) of ciprofloxacin patients versus 6%
(21/349) of comparator patients at 6 weeks
The rates were 13.7% and 9.5%, respectively, at 1 year. Arthropathy
occurred
more frequently in patients treated with ciprofloxacin than control,
regardless of whether
they received IV or oral drug. Ciprofloxacin patients were more likely
to report more than one event and on more than one occasion compared
to control patients (37% [17/46] versus 24% [8/33]).
Arthropathy occurred in all age groups and the rates in the
ciprofloxacin arm were
consistently higher than in the control arm,.
The arthropathy rates in patients treated with oral versus those
treated with IV (IV alone or sequential IV to oral therapy) at six
weeks were different. The arthropathy rates in the oral stratum were
9.1% (27/296) for ciprofloxacin and 6.9% (21/304) for the comparator
groups. The arthropathy rates in the IV stratum were 10.3% (4/39) for
ciprofloxacin and 0% (0/45) for the comparator groups.
The arthropathy rates were similar between males and females and
consistent between
treatment groups. The rates were 13.9% (38/273) and 10.6% (30/284) in
females compared to 12.9% (8/62) and 4.6% (3/65) in males for
ciprofloxacin and comparator, respectively.
Arthropathy rates in patients with cUTI were 12.2% (20/164) for
ciprofloxacin versus 9.6% (16/166) for comparator, and in patients
with pyelonephritis the rates were 6.4% (11/171) for ciprofloxacin
versus 2.7% (5/183) for the comparator.
There was a bigger difference between treatment group arthropathy
rates in the United States (21.0% [13/62] for ciprofloxacin versus
11.3% [8/71] for comparator) than in the overall rates.
The incidence of neurological events from initial dosing through 6
weeks up follow-up was 2.7% (9/335) in the ciprofloxacin group and
2.0% (7/349) in the comparator group.
The overall incidence of adverse events at six weeks was 41% (138/335)
in the ciprofloxacin arm compared to 31% (109/349) in the control
arm...Serious adverse events were seen in 7.5% (25/335) of
ciprofloxacin patients compared to 5.7% (20/349) of the control
patients and discontinuation of drug due to adverse events was seen in
3% (10/335) of ciprofloxacin patients and 1.4% (5/349) of control
patients.
Source:
Division of Special Pathogen and Immunologic Drug Products
Summary of Clinical Review of Studies Submitted in Response to a
Pediatric Written Request
Applications:
19-537/S-049, ciprofloxacin tablets
20-780/S-013, ciprofloxacin oral suspension
19-847/S-027, ciprofloxacin IV 10 mg/mL
19-857/S-031, ciprofloxacin IV 5% dextrose
Applicant: Bayer Corporation, Pharmaceutical Division 400 Morgan Lane
West Haven, Connecticut 06516
Drug Name Established: Ciprofloxacin
Proprietary: Cipro(R)
Route: Oral or IV
More adverse events were seen with Cipro and more patients
discontinued the drug due to these adverse reactions. As such Cipro
has a higher RISK factor than oral cefixime or trimethoprim/
sulfamethoxazole / IV ceftazidime; IV ceftazidime followed by oral
cefixime; and sequential IV ceftazidime to oral trimethoprim/
sulfamethoxazole in regards to manifesting adverse reactions. A 10%
higher risk factor in fact.
Now let's take a look at doxycycline.
Cipro vs. Doxycycline
60 Day Cipro Study
Bottom line: Doxycycline tends to have fewer side effects than Cipro.
(That is why the CDC recommended in November of 2001 that all those
needing antibiotics against anthrax--for treatment and prevention--be
given doxycycline, not Cipro.)
Adverse events at 30 days, by most recent antimicrobial agent, all
sites, 2001-2002
All Adverse events:
Day 30
Ciprofloxacin 77 out of 737 patients stated as 10.5%
Doxycycline 71 out of 2,050 patients stated at 3.4%
The overall rate of reported adverse events reported for Cipro was
16.5% vs. 3.4% for Doxycycline.
Once again more adrs with Cipro than Doxycycline. You will find this
with every other antibiotic currently in clinical use today.
So yes, the "game" is over and you lost. Cipro is NOT a safe
antibiotic. It is every bit as dangerous and at times more so than
any other antibiotic on the market today. 1 in 10 chance of having a
serious joint problem, as well as a 41% chance of having an adverse
reaction. Associated with obstructive uropathy and renal failure due
to cipro induced crystalluria, which you find to be of no importance.
But you are absolutely correct about one thing here in this entire
discussion. I have to be absolutely "loony" to think that you are
even listening to a single word I say.
You see I view you as nothing more than a glorified mechanic who is in
love with his tools. A fraud in white if you would. A true physician
would have shown an interest in the information I provided and
questioned the wisdom of their prescription practices. All you have
done is harass and insult me and side with the drug rep with the 40 DD
chest. You are simply not worth any more effort. Frankly "Doctor" I
don't give a damn whether you believe me or not. I could care less if
you think I am a nutcase.
As such, if you would be kind enough to stop responding with insults
and frivolous opinions we can end this. I'd much rather you remain
silent and thought a fool than to continue to speak up and remove all
doubt as you persist in doing. If you do not wish to listen with an
open mind why then do you continue to beg for a response? Is your ego
so huge you have to have the final word? OK. I'll grant you that
one. Let it be "thanks for playing", instead of another round of
patronization and insults delivered from your elevated pedestal.
I'm not the least bit interested in anything else you have to say, so
don't waste any more of your time or mine by continuing to bait me.
This isn't some kind of sick game where there are winners and losers.
The only ones losing here are your patients. And that quite frankly
is not my problem, but theirs anyhow. Go waste your time on them
instead of me.
You have yet to provide one shred of evidence that the quinolones are
safer than your other choices, which was the subject of this
discussion to begin with. Your opinions are not to be considered
evidence. So far you have proven nothing but the size of your ego as
well as your closed and narrow mindedness. Both of which are quite
admiral attributes to have in a physician I would imagine. Unless you
happen to be the patient.
.
Thanks for playing as well. Game over. Go ahead and think you "won"
if that makes you feel any better. Makes no difference to me one way
or the other. You were playing with yourself anyhow as I wasn't even
playing to begin with.