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Local Doctors Explain Risks Of Taking Levaquin

PITTSBURGH (KDKA) - Some swear by them, others say they're dangerous - if not deadly.

KDKA-TV health editor Dr. Maria Simbra explains why some are calling for a closer look at a certain group of antibiotics.

From time-to-time, Janice Olszewski's mother, Mary, needs to take antibiotics for urinary tract infections.

"She gets very weak, she gets sick. Sometimes, she'll get disoriented," Olszewski said.

Her doctor prescribed a medicine called Levaquin.

"He said it would help clear the infection, and we should get fairly quick results with it. It's been a Godsend for us," Olszewski said. "If it wouldn't be for Levaquin, we'd have a hard time managing her health care.

"I'd say 20-30 times a year, we give a prescription for levofloxacin," Dr. Marc Itskowitz of Allegheny General Hospital's Internal Medicine said. "We try to reserve it for patients who need a broader spectrum antibiotic, may have been exposed to other antibiotics and are still sick. It's very effective in those patients."

Taking it by mouth works the same as taking it by IV. It also comes in an easy-to-swallow liquid. While it kept Janice's mother out of the hospital, not everyone has had a good experience.

Karen Paddock was taking out the garbage when she cut her leg on a broken dish in the trash bag. She got stitches, followed by infection of the skin - cellulitis.

"At that point, they gave her the Levaquin antibiotics for the cellulitis," Bob Paddock said.

Six months later, she developed tendon troubles and couldn't walk.

"It was in 2003, and at that point, I'm not sure all the risks that are known today were known then," Paddock said.

After ten years of using a scooter around the house in chronic pain, at age 43, she committed suicide - four days shy of her 20th wedding anniversary.

Her husband has strong hopes for all similar antibiotics.

"That they either get taken off the market, or they get a whole lot harder for anybody to prescribe," he said.

Levaquin, generically known as levofloxacin, is in a class of drugs called fluoroquinolones.

They work by attacking bacterial DNA, making the bacteria unable to multiply.

Known risks include nerve problems and tendon rupture. Fluoroquinolones are not recommended for people taking steroids, people with a history of seizures, and people with certain heart rhythm abnormalities.

Pharmaceutical watchdog Dr. Charles Bennett is trying to expand the warnings by bringing a citizen's petition to the FDA.

"I've been doing this work so long, that I think patients find me," Dr. Bennett said.

His focus is the rare complication of mitochondrial toxicity.

You can think of mitochondria as your cells' battery packs. Without them, your cells have no energy.

He said if an event happens right after the medicine is given, that would be a reaction. He also has lab researchers who have been able to recreate symptoms in mice.

"There's a little bit of an art, rather than a science. There's not a specific diagnostic test," he said.

He would like to expand the black box warning on Levaquin, or establish a process so that patients must sign that they understand the risks of the drug.

"This would make Levaquin a little bit less attractive to use if it goes through as a black box warning," Dr. Amesh Adalja, of the UPMC Center for Health Securit, said.

This infectious disease specialist said the class of antibiotics does have a role to play, but shouldn't be prescribed automatically.

"Even if you're prescribing penicillin, it's something you have to do with each infection that you treat. You have to make sure is this the right bug that you're treating, and is this the right drug that you're using," Dr. Adalja said.

"For every patient that has been harmed by a medication, there are thousands that have been helped by it. And we don't often hear from them," Dr. Itskowitz said.

"She's had adverse reactions in the past to numerous drugs, so we're always very alert to those types of reactions. And we felt the risks were minimal," Olszewski said.

Hearing from Olszewski, she's thankful her mother had the option of Levaquin.

"Within a couple of days, she starts to feel better," she said.

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