Side effects of Quinsair® (levofloxacin)

Question

Hello,
I (CF patient) have had very unpleasant side effects when using levofloxacin orally. Because of the recommendation of my physician I took it in spite of this for several days, with the result, that the moderate side effects turned to be very strong when taking it again (the foot was massively swollen, beating and hot, strong pain. Another injury is not coming into question). After contacting my CF center, the antibiotic was stopped immediately, the side effects were slowly reversible, walking without pain however, was only after 5 weeks possible.
Only after this I read, that the manufacturer had to publish a red-hand letter, due to massive damage of tendons, that are supposed to be caused by the drug.
Now the physician is recommending that I should inhale the same substance; at the moment I inhale Colistin (I have MRSA and am free of Pseudomonas), however I do not feel well with the recommended change to the substance (due to the mentioned experience) and I do not trust the statement of the physician that it would not be harmful. In the end she was wrong with that once before.
How do you judge the side effects of inhalation compared to oral intake? Can inhalation be recommended without doubts even if the oral intake was causing side effects?
Thank you

Answer

Hello,
as you probably read, in the leaflet of Quinsair® detailed information on possible side effects of the therapy are listed. Here one has to distinguish frequent, less frequent, rare and very rare side effects.
A tendinitis is beneath of an irritation and inflammation and also pain in the extremities listed as a possible side effect. I did not find a statement in the literature about a massive swollen food, accompanied by strong pain. This sounds more like an infection as a cause of the symptoms.
In the end, the occurrence of the above mentioned side effects can not be excluded even if an inhalative therapy with levofloxacin is done. Concerning the inhalative use of the same substance that has caused side effects when used by another way of intake, your CF center has to be involved in the decision and possible alternative therapies should be taken into account.
Best regards,
Wolfgang Gleiber

28.09.2016