Peripheral Artery Disease Wound Treatment

Fluoroquinolones and Peripheral Neuropathy

Peripheral neuropathy, this is an often devastatingcondition in which people develop pain and numbness in their hands and feet. Basicallythey're told on the evening news that they should be taking this or that medication sothat they can get through life. That's treating the smoke and ignoring thefire. Those medicines that you're seeing advertised don't treat the neuropathy, they only treatthe symptoms. But what's causing peripheral neuropathy? Well we know that in America,one of the biggest causes of peripheral neuropathy is being diabetic, which is clearly relatedto the foods that you eat by and large. Becoming a type 2 diabetic dramatically increases yourrisk for having peripheral neuropathy and

in fact being devastated by it. This is adisease that effects 1 in 15 Americans. Let's take a look. So again this is 1 in 15 Americans—thisis 20 million Americans afflicted by this disease, that aside from diabetes, we're toldthe cause is unknown. Well maybe that's not exactly true. Last month, in the journal Neurology,an incredible study was published describing a relationship between what are called fluoroquinolones,and the risk of developing a peripheral neuropathy. You may not know what fluoroquinolones are,but chances are you may have actually been exposed to fluoroquinolone. These are antibioticsused for treating things like upper respiratory

infections and even urinary tract infections.Things like Levaquin and Cipro are commonly used in walk in s. If you have a urinarytract infection, you may have received these mediations. Well, here's what the study showedus: So this is a study published in September2014 that looked at men between age 45 to 80 years of age followed for a 10 year periodand in this group there were over 6,000 cases of peripheral neuropathy. And they comparedthese individuals to about 25,000 aged match controls, and what they found was that riskfor developing this devastating condition called peripheral neuropathy was doubled inthose individuals exposed to this class of

antibiotics called fluoroquinolones. And whatthe researchers also told us is that, and I quote, quot;Fluoroquinolones have been shownto neurotoxic. Oral fluoroquinolones have also been associated with reported cases ofpsychosis and seizures, which similar to peripheral neuropathy have been shown to be acute eventsoccurring within days of fluoroquinolone use. In light of strong evidence of unnecessaryprescribing of oral fluoroquinolones in the United States, ians must weigh the riskof PN against the benefits of prescribing FQ when prescribing these drugs to their patients.quot; We've got to practice medicine under the dictumof quot;above all do no harm.quot; One of our most

well respected peer review journals is nowtelling us that the use of these medications—these fluoroquinolone antibiotics is associatedwith doubling of the risk of peripheral neuropathy. A disease which often is not treatable. Sokeep that in mind the next time you think you need an antibiotic for this or that problem,discuss this study with your treating physician. I'm David Perlmutter.

Katherine Gallagher MD

gt;gt; I think the most important part,especially when dealing with the patients, all vascular patients but in particular patientswith peripheral artery disease is kind of trying to get a comprehensive historyof when the problem began. I lot of times patients who come in andparticularly those who see me have had lots of things done sort of at others or by other physicians. So I think it's really important to kind ofgo over sort of the timeline of everything that has happened and try and getreally good records and information from the patient about the problem itself.

And then based on that information, we will thenkind of go over different treatment options, both the pros and the cons because everything,you know, has a risk benefittype thing, so we'll go over that with the patients sothat they can make a very clear decision about what they want and whatthey're willing to undergo. I always think it's important to look verycarefully at the place that you're going and at the training and the credentialsof the people that you're seeing because not everyone's eventhough everyone may do certain things or say that they do certain procedures, Ithink it's really important to find people

who really specialize in that area and see a lotof that particular problem and have experience and training that kind of backs that up. In particular for vascular surgery, we'retrained in both the interventional aspects, as well as the medical aspects,as well as the surgical aspects. So I feel it gives us a good breath inthe areas that we treat because we're able to offer minimally invasivetreatment if that's appropriate. Now that's not always appropriate. Sometimes patients are more appropriate and thedata would suggest that they would do better

with open procedures or moreof that type of option. So the fact that we can kind of offer bothoptions and just pick out what is best for the patient and also give the patientsome ability to make some decisions themselves if both options are viable, kind ofchoose which one they'd rather have. I think that's really important.

Category: Neuropathy Treatment

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