Even though I knew this information already and had posted on it briefly in a few forums I wanted to document the information that links fluoroquinolones with the older anti-malarial drugs that were known to be very toxic. This is a very basic overview in a nutshell for those who need to know.
I was once discussing FQ’s with a rheumatologist who made the observation that he knew of some chemotherapy agents and anti-malarial drugs that responded the same way as what I was describing the FQ’s of doing but had never heard of an antibiotic acting similarly. After the conversation, my interest was piqued so I put on my Sherlock Holmes cap, something that every floxie does quite frequently, and researched where the FQ’s came from. I read the “Flox Report” again and it lead me to research the link between FQ’s and anti-malarial drugs.
So after I started my search I ran across an article called “The New Quinolones: Back to the Future, by Julian Davies © 1989 The University of Chicago Press.” In this article the author stated that “the quinolones were discovered by accident as a side product in the synthetic preparation of an antimalarial agent.”
The older anti-malarials, the drugs that were discovered in the early 1900’s to fight against the spread of malaria in third world countries; they were very potent and toxic drugs. One older anti-malarial drug, Chloroquine, was discovered in 1934 at Bayer laboratories. This drug later became the predecessor on which today’s FQ’s are based. Cholorquine was considered too toxic for human use and it was not used on humans for over a decade after its discovery until World War II.
In a 2008 medical journal listed on Pubmed titled “Antimalarial Therapy Selection for Quinolone Resistance among Escherichia coli in the Absence of Quinolone Exposure, in Tropical South America” the author’s state, “The pharmacore of the fluoroquinolones and chloroquine are similar. In fact the origins of the quinolone class are from the use of chloroquine as an antimalarial. A compound isolated from the commercial preparation of chloroquine was modified to produce the first marketed quinolone, nalidixic acid. Fluorine was subsequently added to produce the fluoroquinolones, resulting in both an increase in potency and spectrum.” This article actually deals with the fact that the use of chloroquine in tropical countries is producing a FQ resistant strain of bacteria.
What is the significance of all of this? Well for us floxies it is important to know that Chloroquine can be a nasty drug. It has a laundry list of adverse reactions including, gastrointestinal problems especially stomach ache, skin problems including alopecia, itching, and rashes, headache, nervous system problems including psychosis, depersonalization, serious concentration problems, depression, anxiety, confusion, dizziness and peripheral neuropathy, cardiac problems including Qtc prolongation, and severe eye toxicity including blurred vision, extra ocular muscle palsies and retinal toxicity, Hemolysis with G6PD deficiency. And, on top off all of this it has been documented that it can remain in the body for up to five years or longer in measurable doses!
Now back to the rheumatologist that I spoke with at the beginning of this article, I like that doctor and he is well meaning, and I intend on educating him. But, if I can connect the dots with a computer and a few minutes of internet access so can he. There is no excuse for ignorance in the side effects of these drugs or any drugs.