⚠ Antibiotics with the WORST Side Effects (Dangerous Antibiotics) Fluoroquinolones
Summary
TLDRDr. Ken Berry, a family physician, discusses the overprescription of fluoroquinolone antibiotics, which have serious black box warnings for side effects like tendon damage and nerve issues. He highlights that many infections treated with these powerful antibiotics are viral or could be addressed with safer alternatives. Dr. Berry emphasizes the importance of informed consent and questions why doctors continue prescribing such strong medications out of habit or patient expectation. He urges patients to be vigilant and proactive in discussing risks with their doctors before accepting these prescriptions.
Takeaways
- ⚠️ Many doctors overprescribe fluoroquinolone antibiotics, even for mild infections, despite their serious side effects.
- 🦠 Most sinus and bronchial infections are viral, meaning antibiotics like fluoroquinolones are ineffective in 85% of cases.
- 💊 Fluoroquinolones are often used unnecessarily for infections that can be treated with safer antibiotics.
- ⚕️ Doctors should inform patients about the potential severe side effects of fluoroquinolones and obtain informed consent before prescribing.
- 🦵 The black box warning for fluoroquinolones includes risks of irreversible tendon damage, tendonitis, and peripheral neuropathy.
- 🚨 Fluoroquinolones can also cause psychological side effects like anxiety, psychosis, and suicidal thoughts.
- 💡 Doctors may prescribe these antibiotics out of habit or because they feel pressured by patients expecting a prescription.
- 🧠 If a doctor prescribes fluoroquinolones, they should clearly explain that there are no safer alternatives for the specific infection.
- 🏥 These antibiotics are only appropriate in severe, life-threatening cases, such as hospital or ICU settings, where no other options work.
- 📋 Patients should memorize or keep a list of fluoroquinolone drugs and discuss risks with their doctor if prescribed one.
Q & A
What is the main concern Dr. Ken Berry raises about certain antibiotics?
-Dr. Ken Berry raises concerns about the overprescription of fluoroquinolones, a class of antibiotics, which are often prescribed for infections that do not require such strong medications. These antibiotics carry serious risks, including irreversible tendon and nerve damage.
What are some common infections fluoroquinolones are often prescribed for, according to Dr. Berry?
-Fluoroquinolones are often prescribed for sinus infections, bronchitis, skin infections, and bladder infections, even though these are frequently viral and do not require antibiotics, or could be treated with safer antibiotics.
Why are fluoroquinolones considered risky, as per the video?
-Fluoroquinolones come with a Black Box warning, the most severe type of warning by the FDA, due to their potential to cause irreversible damage to tendons (tendonitis, tendon rupture) and peripheral nerves (peripheral neuropathy).
What percentage of sinus and bronchial infections are viral, and why is this significant?
-According to Dr. Berry, 85% of sinus and bronchial infections are viral, which is significant because antibiotics, including fluoroquinolones, do not treat viral infections. Prescribing them in such cases is unnecessary and risky.
What should a doctor do before prescribing fluoroquinolones, according to Dr. Berry?
-Doctors should thoroughly evaluate whether fluoroquinolones are truly necessary. They must also discuss the potential risks with patients and obtain informed consent, ensuring the patient understands the possible irreversible side effects before prescribing these antibiotics.
What does Dr. Berry mean by 'informed consent,' and why is it important?
-Informed consent refers to the doctor discussing the serious risks associated with fluoroquinolones with the patient before prescribing. It ensures the patient is fully aware of potential side effects, such as irreversible nerve damage, before agreeing to take the drug.
In what situations does Dr. Berry believe it is appropriate to use fluoroquinolones?
-Fluoroquinolones should only be used in serious infections when no other antibiotic will work, or in life-threatening situations where the benefits outweigh the risks. They are inappropriate for outpatient settings where other, safer antibiotics are available.
What are some of the other serious side effects of fluoroquinolones mentioned in the video?
-In addition to tendon and nerve damage, fluoroquinolones can cause muscle pain, joint swelling, psychosis, anxiety, insomnia, depression, hallucinations, and gastrointestinal issues like C. difficile-associated diarrhea.
Why do some doctors overprescribe fluoroquinolones, according to Dr. Berry?
-Dr. Berry suggests that some doctors overprescribe fluoroquinolones out of habit, convenience, or due to pressure from patients expecting antibiotics. He also mentions that some doctors may not take the time to explore safer alternatives.
What advice does Dr. Berry give to patients prescribed a fluoroquinolone?
-Dr. Berry advises patients to ask their doctor why a fluoroquinolone is being prescribed, inquire about the Black Box warning, and discuss whether there are safer alternatives. He emphasizes the importance of informed consent before accepting the prescription.
Outlines
⚠️ Antibiotics Misuse and Overprescription Alert
Dr. Ken Berry emphasizes the overprescription of a class of antibiotics called fluoroquinolones, which have serious risks. Despite being overused for common infections like sinusitis, bronchitis, and urinary tract infections—many of which are viral and don’t need antibiotics—these drugs continue to be prescribed unnecessarily. He explains that there are six FDA-approved fluoroquinolones, and these should not be used casually because of their Black Box warning, which highlights potential harm to patients.
🚨 Black Box Warnings: Tendon and Nerve Damage Risks
Fluoroquinolones have a Black Box warning due to risks of irreversible damage to tendons and peripheral nerves. Dr. Berry discusses conditions like tendonitis, tendon rupture, and peripheral neuropathy that can result from these drugs, potentially leading to permanent damage. He stresses the importance of informed consent, where doctors should discuss these risks with patients before prescribing fluoroquinolones, especially in cases of serious conditions like myasthenia gravis, where the risks could outweigh the benefits.
🤔 The Importance of Informed Consent Before Taking Fluoroquinolones
Dr. Berry underscores the concept of informed consent, explaining that patients must be fully aware of the risks before taking fluoroquinolones. He highlights that doctors often fail to discuss the Black Box warnings with patients, depriving them of their right to make an informed decision. He advises that these drugs should only be used when absolutely necessary, such as when no other antibiotics work or the infection is life-threatening.
Mindmap
Keywords
💡Fluoroquinolones
💡Black Box Warning
💡Informed Consent
💡Sinus Infection
💡Tendon Rupture
💡Peripheral Neuropathy
💡Antibiotic Resistance
💡Overprescription
💡Viral Infection
💡C. difficile Infection
Highlights
Doctors are often prescribing a class of antibiotics known as fluoroquinolones, which have a serious FDA Black Box warning.
The fluoroquinolone antibiotics include drugs like ciprofloxacin, levofloxacin, and moxifloxacin.
These antibiotics are frequently over-prescribed for common infections like sinus infections, bronchitis, and bladder infections.
85% of sinus infections, bronchitis, and similar conditions are caused by viruses, which antibiotics, including fluoroquinolones, do not treat.
For bacterial infections, safer, less harmful antibiotics are available, and should be prescribed instead of fluoroquinolones.
Fluoroquinolones carry risks of irreversible damage to tendons, peripheral nerves, and can cause tendonitis, tendon ruptures, and peripheral neuropathy.
Patients with myasthenia gravis should never take fluoroquinolones unless carefully prescribed by a specialist due to increased risks.
Doctors are expected to provide informed consent, meaning they should discuss the serious risks with patients before prescribing these antibiotics.
Common side effects of fluoroquinolones include muscle pain, joint pain, psychosis, anxiety, depression, and even suicidal thoughts.
Fluoroquinolones also disrupt gut bacteria, leading to severe gastrointestinal issues like C. difficile-associated diarrhea.
These drugs are often prescribed out of habit or due to patient expectations, even though safer alternatives exist.
Patients should be vigilant and question their doctors if they are prescribed a fluoroquinolone for a minor infection.
In cases where fluoroquinolones are prescribed, doctors should explain that there are no other antibiotics that can effectively treat the infection.
Fluoroquinolones should only be used in life-threatening infections when the benefits outweigh the risks, especially in outpatient settings.
This over-prescription of fluoroquinolones can be considered inappropriate or borderline malpractice when safer options are available.
Transcripts
I shouldn't have to make this video and
you should not have to watch this video
but when the level of the average
doctor's laziness and or
incompetence reaches a certain level
then I have to reach out to you and say
hey you need to be aware of this even
though you're not a doctor and it's not
your job
this is very important this is about a
class of antibiotics that are very much
over over prescribed in the United
States and in other countries that have
a serious Black Box warning
own the package insert and that harm
thousands of patients a year that should
not be prescribed for common infections
yet still are each and every day I'm Dr
Ken Berry a family physician let me
explain what's going on to you so that
you can be prepared to protect your
yourself and your family in case your
doctor is just not willing to do the job
that they signed up to do
there are currently six different drugs
that are FDA approved in this drug class
and I'm going to put a visual up so you
can look at this maybe take a screenshot
come back and watch this again later and
write these down moxifloxacin
ciprofloxacin ciprofloxacin extended
release
jimifloxacin
levofloxacin andofloxacin these are the
fluoroquinolones
these drugs are very commonly prescribed
by primary care doctors for such such
inconsequential infections as sinus
infections bronchitis skin infections
and bladder infections urinary tract
infections now first and foremost you
should understand that the vast majority
of sinus infections and bronchitis
are caused by viruses which no
antibiotic fights or treats or improves
at all so 85 percent of the time if you
have a sinus infection or an ear
infection or a bronchial infection or a
throat infection
it's a virus no antibiotic on the planet
is going to shorten the amount of time
you're sick is going to fight the virus
is going to heal you faster the average
doctor should know this many of them
seem not to know this at all
so very commonly for a sinus infection
either Levaquin levofloxacin or Cipro
ciprofloxacin is prescribed for a sinus
infection which uh 85 of the time is
viral and the other 15 of the time if it
is bacterial
there are other less harmful less severe
less powerful antibiotics that will
treat the bacterial sinus infection just
fine without all the disastrous side
effects and complications that I'm going
to tell you about in just a minute that
come along with this drug class the same
goes for bronchitis the vast majority of
the time it's viral you don't need an
antibiotic at all in the 15 percent of
cases that are bacterial there are very
inexpensive very safe antibiotics that
will treat that bronchitis just fine
without you having all the potential
side effects that come along with the
fluoroquinolones same goes for bladder
infections and pelvic infections 85
percent of the time they're viral or
fungal uh 15 of the time they are
bacterial but you can take a much
cheaper much safer antibiotic for them
so the question becomes is why are
primary care doctors why are Internal
Medicine doctors Family Medicine doctor
years OB gyns pediatricians uh
gerontologists why are they prescribing
this basically an a nuclear bomb
when all that is needed is just a small
caliber rifle why are they doing that
well
the majority of the time it's out of
habit they've been prescribing Cipro for
bladder infections for years or they've
been prescribing levofloxacin for sinus
infection for years that's just what
they do that's the only tool that they
know how to use in the toolbox
many primary care doctors think that you
expect
to receive an antibiotic prescription if
you have some sort of infection that you
went to the doctor to get checked and
indeed that is true with some patients
they they expect a prescription for an
antibiotic and they'll get upset if they
don't get one now that does Place some
extra pressure on the primary care
doctor to prescribe an antibiotic but
that still doesn't mean that they should
and it definitely does not mean that
they should prescribe one of these
fluoroquinolones so every single drug in
this drug class has a black box warning
that the Physicians should 100 percent
know about
and should 100 of the time discuss with
you before they write the prescription
and before you accept the prescription
fill the prescription and take the
prescription so in this particular case
all of the fluoroquinolones contain a
black box warning saying that they they
could potentially cause irreversible
damage to tendons and to peripheral
nerves so uh tendonitis tendon rupture
peripheral neuropathy these things can
not only happen but they could be
permanent
very very very concerning uh if you have
myasthenia gravis then you absolutely
should never take a fluoroquinolone
unless it's given to you by a specialist
after you've had the discussion hey I
have mg are you sure I should take Cipro
uh and them say yes I understand there
is a risk but the benefits outweigh the
risks so every doctor before they give
you
one of these fluoroquinolones
they should have first of all have an
internal discussion in their own brain
whether they should be writing this
prescription or Not For What diagnosis
they've given you
but every single patient who receives
the fluoroquinolone should give informed
consent
before they take that
antibiotic and what that means is that
the doctor actually had a discussion
with you hey this has got a black black
box box warning it could cause permanent
nerve damage it could cause
permanent tendinitis I just wanted you
to be aware of that I think you need
this antibiotic do you accept the risks
of this antibiotic to which the patient
would either say uh yes or hell no and
that's what informed consent means so
how many of you guys have been given
Cipro or Levaquin or avilox and you're
like no the doctor didn't tell me there
was a black box warning no they didn't
tell me I could have permanent nerve
damage
from taking that so you were not given a
chance to give your doctor informed
consent to use that treatment on you I
think that's kind of a big deal the only
time you should be given a
fluoroquinolone and accept one from your
doctor for a sinus infection a lung
infection or a bladder infection is if
number one the doctor discussed this
with you and you gave informed consent
but and also the doctor said look there
is no other antibiotic that this
bacteria is susceptible to this is the
only one that will work or your
infection is so serious that I think it
endangers your life therefore the the
benefits of taking this fluoroquinolone
outweighs the risks otherwise
that you should never take a
fluoroquinolone in an outpatient setting
now if you're an inpatient in a hospital
especially if you're in the Intensive
Care Unit if you're close to death then
of course we're going to pull out all
the big guns as a doctor and we might
give you things that have potential
potentially significant risks
just to get the benefits that they may
give you because there may be no other
antibiotic in the pharmacy that's going
to save your life but if you're in an
outpatient setting you went to a
doctor's office or an urgent care and
they give you levofloxacin ciprofloxacin
any of the fluoroquinolones and they
don't let you give informed consent and
they don't tell you hey there's no other
drug that will fix this if basically
what happens is they're like I'm a lazy
ass doctor and I don't want to really
look anything up so I've been giving
Cipro for years for sinus infection so
that's what you're going to get that's
completely inappropriate and borderline
malpractice
so the things mentioned in the Black Box
warning are not the only disaster side
effects that the fluoroquinolones are
known for they're also known for muscle
pain muscle weakness joint pain joint
swelling
psychosis anxiety insomnia depression
Suicidal Thoughts hallucinations
and then you can see from the rest of
this chart several of the things now
keep in mind that all the
fluoroquinolones are very powerful
antibiotics and so they're basically
going to carpet bomb your gut bacteria
and so you could wind up having C
difficile Associated diarrhea or a whole
host of other gastrointestinal symptoms
from bloating to diarrhea to
constipation to gut pain to cramping
because you basically carpet bombed all
of the nice friendly bacteria in your
guts so I'm going to put the list of
medications and these are only the ones
that are FDA approved in the United
States if you're in another country
there's quite possibly other brand names
that are not on this list and there may
even be other fluoroquinolones generics
that are not on this list so you're
going to have to do your due diligence
since it's very obvious from the number
of prescriptions written
uh that that pharmacies keep a tally up
that doctors are still grossly over
prescribing the fluoroquinolones for
infections that they should never be
prescribed for so I want you to memorize
this list maybe even print this out and
keep this in your wallet or your purse
uh and then anytime you go to the doctor
with an infection when they give you an
antibiotic prescription you're going to
look on this list and see if it's one of
these and if it is you're going to have
a discussion with your doctor at that
point and say Doc why didn't you tell me
there was a black box warning for this
drug why didn't you tell me that this
could cause Suicidal Thoughts is there
not another antibiotic that you could
have given me besides Cipro or
levofloxacin is that really that's
that's the one that you're going to give
me and after that conversation I think
from that day forward your doctor will
perhaps be on his or her toes as they
should have been anyway and won't make
such a dastardly mistake again I put
links to the FDA web side about the
fluoroquinolones down in the show notes
below please be vigilant we should be
able to trust our doctors when we go to
them with a complaint but very often
we're not able to trust our doctors and
therefore you have to be more Vigilant
when you go to the doctor than you
should have to be I'm sorry about that
but I also want you to be aware this is
Dr Barry I'll see you next time
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