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Discusses Women's Health

Patients often ask me why I don’t prescribe Cipro (ciprofloxacin) as the first line of antibiotic treatment when they have bladder infections. Well here is why: Since 2008 there have been warnings about the fact that this broad-spectrum antibiotic can impact the bacteria in the gut (and cause overgrowth of the “wrong” bacteria) and can also cause tendinitis and tendon rupture. Despite this the fluoroquinolones, which include the well known brands of Cipro and Levoquin have been often prescribed for patients who are diagnosed with sinusitis, bronchitis and uncomplicated urinary tract infections.

An article in the June issue of OB/GYN News reported on new FDA warnings against routine flouroquinolone use. The FDA Advisory Committee met in November 2015 and discussed a recent safety review of these drugs and concluded that this class of antibiotics should be reserved for patients who do not have alternative treatment options. They found that when the flouroquinolones are used as either a tablet, capsule or injectable form, they are associated with “disabling and potentially permanent serious side effects” which can occur alone or together. These side effects can include damage to tendons (tendinitis and tendon rupture), muscles, joints, nerves and the central nervous system.

Based on this data the drug labels and medication guides for all the flouroquinolones will be updated to reflect the new safety information. And obviously, if for some reason a patient is taking this type of antibiotic and reports any side effects, treatment should be stopped immediately. When it comes to simple bladder infections, sinusitis or bronchitis there are many alternative medications. Cipro and Levoquin should not be the first line of therapy. Medical prescribing habits are hard to break… but the more patients know and of course the more doctors are made aware of safety information, the better the likelihood that the right and safest antibiotic will be prescribed when we need it.

And now to a personal matter… If you are my patient you should have received a letter stating that I am closing my practice here in LA at the end of August. (No, I’m not moving away but I want to be able to visit my family in Israel more frequently, travel for Save The Children and devote time to personal activities.) The letter provided information on how to access your chart. If you would like to be seen by me before the end of August please call Judy or Elaine for an appointment. If you would simply like to get your physical chart (which otherwise is digitized and will be sent to a cloud storage facility) you can come to the office to obtain it, but please let my staff know in advance so the chart can be downloaded and made available. I plan to continue my website after the office is closed so stay tuned (or more appropriately, check your inbox!) I will miss all my patients but hopefully we can stay in touch through the net. And happy Fourth of July…May we celebrate our country next year with an amazing female president!

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