http://www.medscape.com/viewarticle/809520
Above is a reminder about the potential side issues associated with fluoroquinolones. Note that I could not see how many reports the FDA had received, but I do question how many since last year alone over 23 million fluorquinolone prescriptions were written. Sadly, note that in some cases the neuropathy is permanent (the cynic in me would question how many of these cases had disability hearings pending).
Lastly, note that topical (otic and ophthalmic) fluoroquinolones have not been implicated for neuropathy.
The take home point from this should be the importance of urine cultures. If this article pushes you "back to bactrim" then please remember to send a urine culture. Sanford's suggests first line fluoroquinolones if local E. coli resistance is above 15-20% for sulfa meds, and from local data I suspect Rex's antibiogram is close to or above this number. Thanks to Dr. Citron for the article referral.
Don't forget the cultures! Empiricism is an academic myth for a non existent lawyerless world!
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