What antibiotics cause anxiety

Someone who has an infection sometimes needs an antibiotic. What most patients do not know is that there is a special group of antibiotics that can cause permanent health problems: the fluoroquinolones such as ciprofloxacin. In the USA, the strictest safety warning for these antibiotics was issued this year. But what is happening in this country? The funds will continue to be widely prescribed. The German drug authority and the Ministry of Health remain inactive.

Announcement: Our next story is about negligent doctors, a sluggish drug agency and an inactive minister. It is about the use of a certain group of antibiotics, the risks of which are underestimated in this country. Caroline Walter and Christoph Rosenthal report on this failure in patient protection.

Stefan Luginger can barely walk. Every step is torture, his Achilles tendons can tear at any time. The 30 year old has joint and tendon pain, his hands and feet burn. He has anxiety, impaired vision, and has trouble concentrating. All side effects that hit him after taking certain antibiotics.

Stefan Luginger

"It's like when a whole world view collapses. In advance, I was able to work, I could do sports, I could do something in the household, which in retrospect is no longer possible. I need help with all the little things, but I live in a world in pain. "

He can only spend most of the time lying down. Eight months ago, he was prescribed the antibiotic ciprofloxacin and then levofloxacin for a burning sensation when urinating. He did not know how dangerous these drugs can be.

Stefan Luginger

"I am very angry that because of a harmless urinary tract infection or a suspected urinary tract infection, you are given drugs that can lead to permanent damage and destroy the rest of your life."

The antibiotic ciprofloxacin is the most common agent from the group of so-called fluoroquinolones. They have been on the market for a long time, but these antibiotics pose a particular risk: torn tendons and a variety of nerve damage. They can also trigger psychosis and anxiety attacks.

The American drug agency FDA issued the highest safety warning this year: this group of antibiotics should no longer be used for harmless infections - because of the dangerous side effects. In the USA there was a broad public education of the patients.

And in this country? No current warnings from the German Medicines Agency. Although many doctors continue to prescribe cipro- or levofloxacin for common infections - despite the high risks.

Wolfgang Becker-Brüser from the renowned independent specialist journal "Arzneitelegramm" has been warning of the side effects of these antibiotics since the 1990s. He accuses the supervisory authorities of inaction.

Wolfgang Becker-Brüser, medicine telegram

"If it is clear that thousands of people will be harmed, maybe even tens of thousands, then action must be taken. There is no chance of giving much thought, but strategies must be sought and found how to protect patients, namely preventive consumer protection is the motto. "

In the USA there is now a warning in bold and framed right at the top of the Cipro package insert, the so-called "Black Box Warning". This highlights the risk of irreversible damage. It is also explicitly stated that Cipro should not be the first choice.

The American drug expert Charles Bennett thinks this is absolutely necessary.

Dr. Charles Bennett, US drug safety expert

"The black box warning is new and revised, it highlights the serious side effects on the central nervous system. After one or two tablets of these drugs, patients can no longer work, think and experience insane pain. This black box as a warning falls on the Immediately in the eye - the doctor and the patient. "

But you will look in vain for this conspicuous warning on the German package insert for Ciprofloxacin. Instead, wide areas of application are still being advertised. Incomprehensible because the fluoroquinolones should only be used against more severe infections - if there are no alternatives.

We asked the German drug authority BfArM why they did not issue a current warning about this group of antibiotics. We don't get an interview. We are told that the side effects are detailed in the package insert. A stressed warning like in America is not considered to be sensible here.

Wolfgang Becker-Brüser, medicine telegram

"It is not at all sufficient if it is in the package insert or in the specialist information. There is so much in it that no person, no consumer and no doctor can see what is in it. There are important things next to unimportant things, and life-threatening things next to them That is why a black box is a very good facility in the USA. A black box that contains exactly what is life-threatening and serious and what the doctor must avoid. "

This patient is also affected. Sven Forstmann did not explain to anyone that these antibiotics should not be used for harmless infections. There was also nothing in the package insert about permanent damage. Forstmann can just go to the mailbox - he doesn't manage more. He and many other injured patients have now launched a petition. They demand that the use of these antibiotics be severely restricted.

Sven Forstmann

"I actually had the impression that I was poisoned from behind, sneakily poisoned, without being warned about it at all. So the drug was prescribed for me by the doctor. I was not warned by the doctor, the clinician, or the pharmacist. Everyone said it was well tolerated and it wasn't at all. I've been unable to work for four months. "

Forstmann wrote to the German Minister of Health. But received no response to his petition.

It is also about the risk of increasing resistance. Because the fluoroquinolones belong to the so-called "reserve antibiotics" - which have to be used sparingly so that they remain effective against life-threatening infections.

But contrasts are current prescription numbers. They prove that the fluoroquinolones are still being prescribed far too widely - especially ciprofloxaxin with over 3.7 million packs in 2015.

"Reserve antibiotics" that are negligently prescribed. Health Minister Hermann Gröhe has long wanted to change this with his antibiotic strategy.

Hermann Gröhe (CDU), Federal Minister of Health

"The global spread of antibiotic resistance must be stopped urgently."

But the implementation is more than sluggish - that criticizes the green member of the Bundestag Kordula Schulz-Asche.

Kordula Schulz-Asche (B'90 / The Greens)

"The prescription as a whole is actually irresponsible. It is at the expense of the patient, the individual patient, but it is also at the expense of society, because if we no longer have reserve antibiotics for certain infections, then more and more people will die because we do not Have more drugs available. "

As it turned out later, Stefan Luginger didn't need any antibiotics at all for his symptoms. There is no therapy for the damage caused by the drug. His prognosis is uncertain.

Abmoderation: The Federal Ministry of Health answered us in writing. A black box warning like in the USA for these antibiotics is not considered necessary here. By the way, if you are taking one of these drugs and have any questions about it - please talk to your doctor about it.

Contribution by Caroline Walter and Christoph Rosenthal