The Fluoroquinolone Toxicity Research Foundation

 
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Reversible visual loss in a patient receiving high-dose ciprofloxacin hydrochloride (Cipro)

Vrabec TR, Sergott RC, Jaeger EA, Savino PJ, Bosley TM.

Neuro-Ophthalmology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107.

Bilateral acute visual loss characterized by cecocentral scotomas and acquired dyschromatopsia developed in a patient receiving large oral doses of ciprofloxacin hydrochloride (Cipro). The visual defects improved after cessation of this antibiotic. To our knowledge, this association has not been described previously. The use of this medication in high doses must be accompanied by careful monitoring of optic nerve function.
Neurotoxicity of antibacterial therapy.

Thomas RJ.

Department of Internal Medicine, James H. Quillen College of Medicine, East Tennessee State University, Johnson City 37614.

The increasing variety of drugs available for the treatment of bacterial infections has simultaneously increased the potential for toxicity. Neurologic toxicity of antibacterial therapy is generally underestimated in scope and severity; it may be classified as central, peripheral, or due to drug-interactions, several of which are potentially life-threatening. beta-Lactams and the quinolones are the drugs most commonly associated with seizures and encephalopathy. Drug-induced ototoxicity is common, and sensitive tests are now available for early diagnosis of both cochlear and vestibular toxicity. Testing in clinical practice is best restricted to subgroups at high risk. The aminoglycosides, tetracyclines, clindamycin, erythromycin, polymyxins, and possibly ampicillin have the potential to aggravate neuromuscular disease. Ethambutol, isoniazid, and chloramphenicol are toxic to the optic nerve; bismuth can cause a myoclonic encephalopathy. A number of less common and/or unusual toxicities are also discussed.