what is the treatment for arthralgia from floroquinolones

Fluoroquinolone-induced arthralgia and myalgia in the treatment of sinusitis Abstract Background: Because of their broad-spectrum coverage, fluoroquinolone antibiotics are widely used in the treatment of acute sinusitis and acute exacerbations of chronic sinusitis. Generally, they are well tolerated, and adverse effects are usually mild.

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Does fluoroquinolone cause arthralgia?

Fluoroquinolone-induced arthralgia and myalgia in the treatment of sinusitis Abstract Background: Because of their broad-spectrum coverage, fluoroquinolone antibiotics are widely used in the treatment of acute sinusitis and acute exacerbations of chronic sinusitis. Generally, they are well tolerated, and adverse effects are usually mild.

What are fluoroquinolones used for?

Because of their broad-spectrum coverage, fluoroquinolone antibiotics are widely used in the treatment of acute sinusitis and acute exacerbations …

Are fluoroquinolone antibiotics effective in the treatment of chronic sinusitis?

Fluoroquinolone-induced arthralgia and myalgia in the treatment of sinusitis. Am J Rhinol. 2005; 19(4):395-9 (ISSN: 1050-6586) O-Lee T; Stewart CE; Seery L; …

How long should fluoroquinolone be taken for AUP?

Mar 10, 2020 · The fluoroquinolones are a family of broad spectrum, systemic antibacterial agents that have been used widely as therapy of respiratory and urinary tract infections. Fluoroquinolones are active against a wide range of aerobic gram-positive and gram-negative organisms. Gram-positive coverage includes …

How do you treat fluoroquinolone tendonitis?

After identifying the severity of involvement in a case of tendinopathy induced by a FQ antibiotic, treatment should include rest and decreasing the physical load on the tendon. Treatment with a FQ should be discontinued and physical therapy initiated.

How is fluoroquinolone toxicity treated?

The most frequently prescribed drugs are ciprofloxacin (CIP), norfloxacin (NOR), and levofloxacin (LEV). FQs employ their antibacterial effect by preventing bacterial DNA from unwinding and duplicating which takes place by inhibition of bacterial topoisomerase and gyrase.Aug 20, 2017

How do you reverse Cipro toxicity?

Reducing the Toxicity of Fluoroquinolone Quinolone absorption is markedly reduced with antacids containing aluminium, magnesium and/or calcium. Other metallic ion-containing drugs such as sucralfate, iron salts, and zinc salts, can also reduce absorption. However, this may also result in therapeutic failure.Apr 17, 2021

Is arthralgia side effects of fluoroquinolones?

Conclusion: Although effective and generally well tolerated in the treatment of sinusitis, fluoroquinolone antibiotics may produce adverse effects of arthralgia and/or myalgia.

Which antibiotics are fluoroquinolones?

FDA-approved fluoroquinolones include levofloxacin (Levaquin), ciprofloxacin (Cipro), ciprofloxacin extended-release tablets, moxifloxacin (Avelox), ofloxacin, gemifloxacin (Factive) and delafloxacin (Baxdela).Jul 10, 2018

What are the side effects of fluoroquinolones?

Common side effects of fluoroquinolones include nausea, diarrhea, vomiting, abdominal pain or discomfort, and trouble sleeping. Some patients also develop sensitivity to sunlight and ultraviolet light, such as the lights used in tanning salons.

Can Cipro cause muscle and joint pain?

Fluoroquinolone medicines (which contain ciprofloxacin, levofloxacin, lomefloxacin, moxifloxacin, norfloxacin, ofloxacin, pefloxacin, prulifloxacin and rufloxacin) can cause long-lasting, disabling and potentially permanent side effects involving tendons, muscles, joints and the nervous system.Nov 16, 2018

How common is nerve damage from Cipro?

Common antibiotic may increase nerve damage and peripheral neuropathy risk. Summary: Fluoroquinolone antibiotics, such as Levofloxacin and Ciprofloxacin, appear to increase the risk of peripheral neuropathy by 47%. However, there is no significant increased risk of developing neuropathy associated with amoxicillin use.May 14, 2019

Is Cipro worth the risk?

A 2015 systematic review concluded that Cipro is a safe and effective drug for treating UTIs most of the time and that adverse events were lower than with other antimicrobial treatments.

Who should not take fluoroquinolones?

The FDA advises that health care providers should not prescribe systemic fluoroquinolones for patients who have an aortic aneurysm or are at risk of an aortic aneurysm (such as patients with peripheral atherosclerotic vascular diseases, hypertension, certain genetic conditions such as Marfan syndrome and Ehlers-Danlos ...Nov 15, 2019

Are fluoroquinolones photosensitivity?

Some of the fluoroquinolones induce mild photosensitivity reactions, such as erythema of sun-exposed skin, with varying frequency; however, drugs such as lomefloxacin and sparfloxacin with a C-8-fluorine substituent and clinafloxacin with a C8-chlorine substituent, exhibit a greater incidence of phototoxic reactions ...

Why do fluoroquinolones cause tendon rupture?

Apart from several case reports and case series, one case-control study suggested that quinolones increase the risk of Achilles tendon rupture. Quinolones are antibacterial agents that act by inhibiting bacterial DNA gyrase.

What are the complications of fluoroquinolone?

Fluoroquinolone antibiotics are associated with a wide spectrum of musculoskeletal complications that involve not only tendon but also cartilage, bone, and muscle. Insights into the pathoetiology of fluoroquinolone toxicity on musculoskeletal tissues have been evolving over recent years. Although the pathoetiology is certainly multifactorial, alterations in cell signaling proteins and direct toxic effects on musculoskeletal tissues have been strongly implicated. Increasing age and concomitant systemic corticosteroid use appear to significantly increase the risk of adverse events. The purpose of this article is to review the musculoskeletal complications associated with use of fluoroquinolone antibiotics by adults; identify risk factors associated with fluoroquinolone toxicity; explore the possible pathoetiology of fluoroquinolone toxicity on tendon, cartilage, bone, and muscle; and offer recommendations regarding evaluation and treatment of fluoroquinolone-associated musculoskeletal complications. In addition, this review will provide recommendations regarding fluoroquinolone use in athletes and return to play after fluoroquinolone exposure.

What is the musculoskeletal system?

The musculoskeletal system can be a target organ for adverse drug reactions (ADRs). Drug-induced muscle, bone or connective tissue injuries may be due to, i), primary direct drug action, or, ii), undirected consequence of generalized drug-induced disease. Musculoskeletal ADRs may be only temporarily disabling, such as muscle cramps, as well as in other cases may be serious and life-threatening, such as rhabdomyolysis. In the last few years there has been an increasing awareness of musculoskeletal ADRs. Some recent drug safety issues dealt with serious or uncommon musculoskeletal reactions like rhabdomyolysis associated to statins and tendon rupture associated to fluoroquinolones. In this review, we firstly selected those drug classes having a significantly high percentage of musculoskeletal disorder reports in the WHO adverse drug reaction database, maintained by the Uppsala Monitoring Centre. Secondly, the different musculoskeletal ADRs were closely analyzed through the data obtained from an Italian interregional ADRs spontaneous reporting database. The findings on drugs associated to different musculoskeletal disorders, have been integrated with a review of the epidemiological data available in the literature. For the most involved drugs (HMG-CoA reductase inhibitors, fluoroquinolones, corticosteroids, bisphosphonates, retinoids) the underlying musculoskeletal ADR mechanisms were also reviewed and discussed.

Does pyrazinamide cause joint pain?

Background: Joint pain is frequently observed in patients on antituberculous treatment, and pyrazinamide is known to be associated with joint pain in patients receiving antituberculous treatment. Fluoroquinolone-associated joint pain and tendon injury have been reported in long-term corticosteroid and transplant recipients, but data are lacking in patients with tuberculosis. Objectives: The objective of this study was to examine the incidence of joint pain manifested during administration of antituberculous therapy and their association with fluoroquinolones. Methods: Patients diagnosed with tuberculosis attending the outpatient clinic over a period of 1 year were reviewed and divided into 3 groups: group A receiving pyrazinamide, group B receiving a fluoroquinolone, and group C receiving both pyrazinamide and a fluoroquinolone. Latency to onset of joint pain was noted in all 3 groups. Joint pain was initially managed with analgesics, and associated hyperuricemia was treated with allopurinol/febuxostat. Causative drugs were stopped in case of intolerable joint pain. Results: 260 patients (47% females, aged 38 ± 18 years; mean ± SD) were included [group A (n = 140), group B (n = 81), and group C (n = 39)]. Overall, 76/260 (29%) patients developed joint pain: group A - 24/140 patients (17%), group B - 32/81 patients (40%), and group C - 20/39 patients (51%). The median latency to the onset of joint pain was 83 days (interquartile range, IQR 40-167): 55 days (IQR 32-66) in group A, 138 days (IQR 74-278) in group B, and 88 days (IQR 34-183) in group C. Hyperuricemia was present in 12/24 (50%) patients in group A and 11/20 (55%) patients in group C. Pyrazinamide was stopped in 7/140 (5%) patients in group A, fluoroquinolones in 6/81 (7%) patients in group B, and both pyrazinamide and fluoroquinolones were stopped in 5/39 (13%) patients in group C because of intolerable joint pain. Major joints affected were knees and ankles. Conclusion: There is a high incidence of joint pain in patients receiving antituberculous treatment, which is higher when fluoroquinolones or the pyrazinamide-fluoroquinolone combination are administered as compared to pyrazinamide alone.

Is fluoroquinolone safe for AF?

Background Fluoroquinolones are in wide clinical use as safe and effective antibiotics. Articular cartilage, tendons, and epiphyseal growth plates have been recognized as targets of fluoroquinolone-induced connective tissue toxicity. However, the effects of fluoroquinolones on annulus fibrosus (AF) cells are still unknown. Material/Methods The main objective of this study was to investigate the effects of levofloxacin, a typical fluoroquinolone antibiotic drug, on rat AF cells in vitro. Rat annulus fibrosus (RAF) cells were treated with levofloxacin at different concentrations (0, 10, 20, 30, 40, 60, 80, and 90 μg/ml) and were assessed to determine the possible cytotoxic effects of levofloxacin. Inverted phase-contrast microscopy was used to accomplish the morphological observation of apoptosis of treated cells. Western blot and real-time quantitative RT-PCR (qPCR) was used to explore the expression of active caspase-3 and MMP-3. Flow cytometry was used to measure the apoptotic incidences. Results Our study showed that levofloxacin, with concentrations at 30, 60, and 90 μg/ml, induced dose-dependent RAF cell apoptosis and higher expression of caspase-3 and MMP-3. More apoptotic cells were observed by inverted phase-contrast microscopy. Moreover, levofloxacin increased the activity of caspase-3, and it also reduced cell viability with different concentrations ranging from 10 to 80 μg/ml. Conclusions Our study results suggest that levofloxacin has cytotoxic effects on RAF cells, characterized by enhancing apoptosis and reducing cell viability, and indicate a potential toxic effect of fluoroquinolones on RAF cells.

Is cefdinir good for rhinosinusitis?

Cefdinir shows rapid oral absorption and good respirator y tissue penetration, and may be administered once daily. In randomised clinical trials, cefdinir showed efficacy similar to that of other recommended regimens in the treatment of acute bacterial rhinosinusitis, namely amoxicillin/clavulanate and levofloxacin. Cefdinir is well tolerated and has shown a low propensity to suppress the normal commensal flora. Cefdinir oral suspension is rated highly by children in terms of its taste and smell. As the only once-daily beta-lactam currently recommended by acute bacterial rhinosinusitis guidelines (for first-line use in patients with mild acute bacterial rhinosinusitis and no recent antibacterial use), cefdinir offers a convenient and attractive treatment option.

Does quinolone affect synovium?

However, the effects of quinolones on synovium have not been deciphered completely. In this study, our main objective was to investigate the effects of levofloxacin, a typical quinolone antibiotic drug, on fibroblast-like synoviocytes (FLSs) in vitro. FLS of rabbits were treated with levofloxacin at different concentrations (0, 14, 28, 56, 112 and 224μM). The possible cytotoxic effects of levofloxacin on FLS were determined. Levofloxacin significantly reduced the cell viabilities, gene expression of hyaluronan synthase-2 (HAS-2), and the level of hyaluronan in FLS. Moreover, levofloxacin-induced concentration-dependent increases of apoptosis and active caspase-3 were determined in this study. Ultrastructural damages of FLS were observed by electron microscopy. The mRNA expression levels of matrix metalloproteinase (MMP)-3 and MMP-13 were increased in FLS treated with levofloxacin. In addition, levofloxacin played a role in suppressing the expression of interleukin (IL)-1 and IL-6. Our data suggest that the cytotoxic effects of levofloxacin on FLS were shown to be able to affect cell viability and HA synthesis capacity. The potential mechanisms of the cytotoxic effects may be attributed to the apoptosis and increased expression of MMPs.

Can drugs cause arthritis?

A large and heterogeneous group of drugs can cause drug-induced arthritis. No single pathogenetic mechanism or drug class unifies these diverse culprits. Recognizing that joint symptoms may, in fact, be drug-related not only saves time and unnecessary investigations but can also prevent needless suffering and morbidity due to late recognition of a drug-induced arthritic condition. The extent of drug-induced arthritis is variable and ranges from minor short-lived and reversible arthralgia to a prolonged and occasionally destructive arthritis. The onset of arthritis due to various medications in relation to the timing of drug initiation is also variable and may range from a few days to several months.

What is fluoroquinolone?

The fluoroquinolones are a family of broad spectrum, systemic antibacterial agents that have been used widely as therapy of respiratory and urinary tract infections. Fluoroquinolones are active against a wide range of aerobic gram-positive and gram-negative organisms.

What is Gram negative?

Gram negative coverage includes Neisseria meningitides and gonorrhoeae, Haemophilus influenzae, and most clinically important Enterobacteriaceae species, Pseudomonas aeruginosa and Vibrio species. The fluoroquinolones are believed to act by inhibition of type II DNA topoisomerases (gyrases) that are required for synthesis of bacterial mRNAs ...

Is ciprofloxacin a fluoroquinolone?

The fluoroquinolones currently available in the United States include ciprofloxacin, gemifloxacin, levofloxacin, moxifloxacin, norfloxacin, and ofloxacin. These agents are well absorbed orally and well tolerated with a low rate of adverse effects. Several quinolones and fluoroquinolones were introduced but were subsequently withdrawn ...

Can fluoroquinolone be given to pregnant women?

Fluoroquinolone Drugs Damage Connective Tissue. Fluoroquinolone drugs are extremely damaging to connective tissue, which have caused them to be banned from being given to children, teens, and pregnant women, and was first discovered by giving Levaquin to Dogs.

Can fluoroquinolone cause arthritis?

We certainly can’t know this for sure, but we do know that there are thousands of people who claim that their arthritis was triggered by the Fluoroquinolone antibiotics, and that science tells us that reports of drug induced arthritis from the Fluoroquinolones are common.

What are the symptoms of arthralgia?

Symptoms. The primary symptom of arthralgia is joint pain, which may be described as dull, sharp, stabbing, shooting, burning, throbbing, or aching. Arthralgia can range in intensity from mild to severe, and it can appear suddenly or develop more slowly and get worse over time.

What is arthralgia pain?

Treatment. Complications. Arthralgia is a term used to describe aching or pain in one or more of the joints in the body. There are many different causes of arthralgia, including various forms of arthritis and other ailments, injury, infection, and allergic reaction to medication or food. Arthralgia can be experienced anywhere you have ...

Can arthralgia be left untreated?

It’s important to be aware that arthralgia has the potential for serious complications if the joint pain or its underlying condition is left untreated, or not treated properly. That's why it's a good idea to discuss and implement a treatment plan with your doctor or healthcare professional to minimize the risk of complications, including:

Is arthralgia life threatening?

While arthralgia itself is typically not life-threatening, you should seek immediate medical attention if you experience: Severe, unexplained joint pain that lasts for more than several days. Fever not associated with flu or other virus. Sudden loss of more than 10 pounds without trying.

Who is Cristina Mutchler?

Cristina Mutchler is an award-winning journalist with more than a decade of experience in national media, specializing in health and wellness content. A multilingual Latina, Cristina's work has appeared on CNN and its platforms, local news affiliates across the country, and in the promotion of medical journal articles and public health messaging.

Is it helpful to have a doctor diagnose arthralgia?

When it comes to arthralgia, a doctor's diagnosis is extremely helpful to ensure you're getting the proper treatment . For example, you could think you have arthritis, when your arthralgia is actually a sign of a different underlying health condition.

Is arthritis the same as arthralgia?

Arthralgia and arthritis are similar, so it's easy to get them confused. Because they both deal with joint pain, the terms arthralgia and arthritis are sometimes used interchangeably. Technically, arthralgia is a symptom that refers to joint pain, while arthritis is a health condition that has symptoms of inflammation and pain in the joints. 2

What are the side effects of fluoroquinolones?

Nausea and vomiting are the most common side-effect of the fluoroquinolones. The group of side-effects includes nausea, vomiting, abdominal pain, diarrhea, and taste disturbance, which occur in about 2-20% of people taking fluoroquinolones. This rate is similar to those seen with azithromycin and cefixime. The highest rates occurred among older agents, which have been discontinued. Newer agents have lower rate of GI side-effects. C. difficile -associated diarrhea (CDAD) has been associated with all antibiotics. When compared to other antibiotics, however, the risk of CDAD was found to be 2.5 times greater with fluoroquinolones. Fluoroquinolones are associated with an increased risk of pseudomembranous colitis

What is the mechanism of toxicity of fluoroquinolones?

The mechanisms of the toxicity of fluoroquinolones has been attributed to their interactions with different receptor complexes such as blockade of the GABAa receptor complex within the central nervous system, leading to excitotoxic type effects and oxidative stress.

How do fluoroquinolones affect DNA replication?

The fluoroquinolones exert their therapeutic effects by interfering with bacterial DNA replication by inhibiting an enzyme complex called DNA gyrase. Research has indicated that fluoroquinolones at therapeutically used doses have little effect on enzymes involved in DNA replication in mammalian cells including human cells; however, not all subtypes of eucaryotic topoisomerases have been routinely studied in clinical studies. In vitro studies in human fibroblast cells have shown that nalidixic acid can impair repair type DNA synthesis at a relatively low dosage (5 ug/ml), but this effect is seen only at very high doses (at least 50 ug/ml) of other quinolones ( ciprofloxacin, norfloxacin, and ofloxacin) tested. Fluoroquinolones increase the uptake of deoxyuridine, uridine, and thymidine into the DNA of human lymphocytes and decrease pyrimidine production. A reduction in leucine occurs. With some quinolones, these effects appear to occur at therapeutic dose levels. Quinolones also appear to effect the growth of eucaryotic cells and HeLa cells. However, relatively high doses of quinolones (20 ug/ml) are required to impair eucaryotic cell growth. At doses that are achievable in therapeutic dosing of (5 ug/ml), a 50% reduction in lymphocyte immunogloblin production occurs. DNA damage such as strand breaks, occurs only at extremely high doses of fluoroquinolones (above 100 ug/ml). DNA polymerase a, topoisomerase I, topoisomerase II, and mitochondrial function are inhibited only at high doses of quinolones above the dosages that would be seen in clinical practice. Some quinolones have been shown to be capable of causing injury to the chromosome of eukaryotic cells. As such, some fluoroquinolones may cause injury to the chromosome of eukaryotic cells. There is some debate in the medical literature as to whether these DNA effects are to be considered one of the mechanisms of action concerning some of the severe ADRs and toxicities experienced by some patients following fluoroquinolone therapy. It has been speculated that the effects of fluoroquinolones on human eukaryotic topoisomerases have potential to cause cytotoxicity. Fluoroquinolones may have the potential to cause clastogenicity and the induction of micronuclei. Retinal pigment epithelial cells are critical to the functioning of the eye and are involved in many eye diseases. In one study, DNA damage to RPE cells was observed with Sparfloxacin.

Is levofloxacin a class effect?

The most common adverse effects of the fluoroquinolones involve the gastrointestinal tract, skin, CNS, and PNS. They are for most patients mild and reversible. Severe adverse events such as hepatitis (trovafloxacin), hemolytic uremic syndrome (temafloxacin), and eosinophilic pneumonitis are thought to be specific to individual agents and as such not considered to be a class effect. However, levofloxacin, ofloxacin, ciprofloxacin, and moxifloxacin have all been reported to be associated with liver injuries such as hepatotoxicity, hepatic failure, and delayed and prolonged cholestatic hepatitis.

Can fluoroquinolone cause joint pain?

Joint pain and swelling occurs in approximately 1% of people taking fluoroquinolones and usually remits within days of stopping treatment. A rare but serious adverse reaction with fluoroquinolones involves spontaneous tendon ruptures. Such injury to the patient include ruptures of various tendons (other than just the Achilles) and muscles, as well as damage to the cartilage and ligaments. Fluoroquinolones also have adverse effects on cartilage. The risk of tendon disorders with fluoroquinolone use is 0.1% to 0.4% or 3 cases per 1000 patient-years of exposure. These problems usually start 13 days after treatment was started and may possibly persist for a month. Risk of tendon rupture is even less with only 38 of 46,000 people treated with fluoroquinolone suffering a rupture of the achilles. This is 1.9 times the rate seen in the general population. The achilles is the most common tendon affected. This risk is greatest in those older than 60, in those taking corticosteroid drugs, and in kidney, heart, and lung transplant recipients. Because of their possible negative effect on cartilage, they are not recommended for use in pregnant women or children. The FDA recommends stopping treatment, contacting a physician and resting affected limbs if these adverse events occur.

Why was temafloxacin removed from the market?

However, Temafloxacin was removed from clinical use in 1992 due to its side-effects of hemolytic anemia (destruction of red blood cells) and other blood cell abnormalities; kidney dysfunction requiring renal dialysis (in 50% of patients affected); and severe liver dysfunction.

Is fluoroquinolone a bacterial antibiotic?

Fluoroquinolones are often effective as antibacterial agents. They are recommended for a number of serious bacterial infections, and, in some cases of life-threatening infections, they can be life-saving. The distinction between a quinolone drug and a fluoroquinolone drug is the addition of the fluorine atom to the basic pharmacophore, resulting in a fluorinated drug. The terms fluoroquinolone and quinolone are often used interchangeably, without regard to this distinction.

How to treat arthralgia?

Minor arthralgia can be treated at home with over-the-counter medications that reduce pain and swelling, or by icing, taking warm baths, or stretching. More severe cases of arthralgia may benefit from medical procedures, such as steroid injections, joint aspiration, or physical therapy.

What is the best treatment for joint inflammation?

If appropriate, over-the-counter medications may be used to reduce pain and swelling. In some cases, physical therapy may be beneficial. Steroid injections are a common treatment for joint inflammation. If needed, fluid may be removed from the affected joint in a procedure called joint aspiration ( arthrocentesis ).

Why does my arthralgia hurt?

Arthralgia with sudden joint pain may be caused by an injury, while arthralgia that develops and worsens over time may be due to an underlying disease or disorder. The most common cause of arthralgia is arthritis, which is inflammation of the joints.

What is the pain in one or more joints?

Arthralgia is pain in one or more of your joints. The pain may be described as sharp, dull, stabbing, burning or throbbing, and may range in intensity from mild to severe. There are many causes of arthralgia, including injury, infection, arthritis, and other ailments. The most common cause is arthritis, which is inflammation of the joints.

What is the most common bacterial infection in young adults?

Mumps (viral infection of the salivary glands in the neck) Neisseria gonococcus (bacterial infection more common in adolescents and young adults) Salmonella (bacterial infection more common in sickle cell patients) Staph aureus (bacterial infection following trauma or surgery)

What is the disease of the spinal cord?

Spondylitis (infection or inflammation of the spinal joints) Systemic lupus erythematosus (disorder in which the body attacks its own healthy cells and tissues) Tendinitis. Tumors of the bone, joints, or soft tissues.

Can complementary medicine help with arthralgia?

Some complementary treatments may help some people to better deal with arthralgia. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for traditional medical care.