Cipro Tendon Injury Still Plagues Anthrax Attack VictimAug 8, 2008 | Parker Waichman LLP
Victims of the 2001 anthrax attacks are still dealing with some difficult health issues. Surprisingly, their difficulties have nothing to do with the deadly virus itself, but rather were caused by Cipro, the medicine that was supposed to make them well.
Cipro belongs to the antibiotic group known as fluoroquinolones. Fluoroquinolones are known to carry a number of risks. These include liver problems and tendon damage. The first fluoroquinolone was introduced in 1986, but they are really modified quinolones, a class of antibiotics discovered in the early 1960s. Critics of these drugs allege that fluoroquinolone antibiotics were developed and put on the fast track for Food & Drug Administration (FDA) approval without the benefit of adequate premarket testing to accurately determine the probability of certain side effects within the general population. After gaining FDA approval, the new fluoroquinolone antibiotics were aggressively marketed by the manufacturers.
Cipro became widely known when it was used to treat and prevent anthrax infections in people exposed to the virus as a result of the 2001 mail attacks. While Cipro was apparently an effective weapon against anthrax, it left some victims with lingering health problems.
One of those was John Angell, who was working on Capitol Hill as staff director for Senator Max Baucus (D-Mont.) when the anthrax attacks occurred. While not diagnosed with anthrax, like hundreds of other people, Angell took a course of Cipro to prevent infection. He told The Wall Street Journal that a few days later, he felt pain in both his Achilles tendons. A week after that, the pain had grown so bad that he talked to a doctor, who switched him to another antibiotic.
Angell's Cipro injury was so bad, that he became all but immobile for a time. He had to undergo rehab, and missed a great deal of work. He had to give up his staff director position, and now holds a much less senior job. Even today, Angell still walks with a cane and can’t hike or play tennis the way he used to.
Last month, the FDA asked the manufacturers of Cipro and other fluorquinolones to add a black box warning to the drugs' labels about their association with tendon damage. The FDA said the risk of tendon damage was greatest for those over age 60, those on concomitant steroid therapy, and kidney, heart, and lung transplant recipients. The ruptures generally related to the use of fluoroquinolones involve the Achilles tendon as well as ruptures of the shoulder, hand, biceps, and thumbs
Unfortunately, the new black box warning came too late for John Angell and many others like him.