Special addendum: side effects of CIPRO-like drugs may be worse than Anthrax; CIPRO should not be used by rescue, police or military personnel, nor be approved for nation's antibiotic stockpile.
America is losing its other germ war and thousands more lives are needlessly being lost than from the recent anthrax threat.
The public has been gripped by the threat of anthrax in the past week, and has become familiar with CIPRO (ciprofloxacin-Bayer), the antibiotic that has been widely described as the preferred drug to treat inhalation anthrax.
At the same time, Americans have been distracted from America's other germ war the over-use of prescription antibiotics like CIPRO which will only hasten the early demise of millions of humans worldwide as more germs mutate and become resistant to these drugs, permitting bugs like E. coli, Enterococci, Staphylococcus, Helicobacteri pylori, and yes even anthrax, to escape treatment and increase morbidity and mortality. The ongoing germ war Americans face is not administered by a terrorist but is of one their own doing.
A news story that has been overshadowed by the American anthrax scare is that FDA and University of Maryland researchers found 20% of meat samples obtained from supermarkets were contaminated with drug-resistant salmonella, a germ that is responsible for 1.4 million cases of food poisoning annually. Among the samples of ground beef, chicken turkey and pork, 84% of the salmonella was found to be resistant to one drug and 53% to three or more antibiotics.1
Worldwide, many strains of Staph aureus, another pathogenic bacterium, are resistant to all antibiotics except Vancomycin, which is considered the antibiotic of last resort. Strains of germs like Enterococcus faecalis, Mycobacterium tuberculosis and Pseudomonas aeruginosa already defy a stockpile of more than 100 antibiotic drugs.
The FDA is rapidly making plans to reduce the use of antibiotics in animals, particularly because the drug-resistance in these animals can be transferred to humans. Over 40% of the antibiotics produced annually (about 20 million pounds) are used in animals.
In an attempt to head off the growing drug-resistance problem, the American Medical Association has urged its members not to prescribe CIPRO to patients who are merely worried about anthrax exposure and has warned physicians to reduce their rate of prescriptions for antibiotics overall. Some experts estimate half of the antibiotics taken in the US are unnecessary.
Most commercial antibiotics have been molecularly altered in the laboratory to obtain a patent and to improve potency. The man-made molecules are what induce germs to mutate and become resistant to their killing properties.2 Drug companies have responded to the resistance problem "by producing newer antibiotics," most which are just variations or combinations of old drugs.3 The FDA says it is doing all it can to speed up development and availability of new antibiotic drugs.4 For example, in September of 1999 the FDA announced the "approval of a long-needed new weapon against the growing threat of drug-resistant bacteria: Synercid, the first alternative in 30 years to the antibiotic (vancomycin) of last resort." Synercid (Rhone-Poulenc Rorer) is the first in a new class of antibiotics called streptogamins, but the FDA admitted it only has a 52% effectiveness rating in fighting off drug-resistant strains of enterococcal infections and it was accompanied by side effects such as rash, vomiting, diarrhea and joint pain.5
But the FDA makes no mention of natural, non-patentable antibiotics which do not induce resistance, some which exhibit a 100% kill factor for anthrax and a wide range of other germs. There are no financial incentives for makers of antibiotic foods like garlic, or supplements like oil of oregano, to undergo expensive and time-consuming clinical trials so they can make a label claim as an antibiotic. This gives drug manufacturers complete reign over the prescription antibiotic drug market. Most Americans are so ill informed on this issue that they just can't believe natural antibiotics are more potent than the drugs their doctor prescribes.
Physicians could direct their patients to natural antibiotics that don't induce resistance, but they have largely been trained to use prescription medications and to look askance at natural remedies as if they are snake oil. This problem is already costing many patients with their lives as the antibiotic drugs fail to cure pneumonia or other hospital-acquired infections. An estimated 14,000 hospitalized patients are believed to die from drug-resistant bacteria annually. That's far more than the current anthrax exposure.6
In order to maintain profits of the pharmaceutical companies and physicians, the FDA requires the public to play a risky game, to wait for infection to occur, then run to the doctor, risk death or chronic health problems, receive a broad-spectrum antibiotic while the doctor sends a swab sample to the laboratory for culture to see if the prescribed antibiotic will defeat that particular kind of germ. There are over 76 million cases of foodborne infection annually in the US which produces diarrhea and 5000 deaths annually.7 These deaths could be prevented if the manufacturers of natural antibiotics like garlic and oil of oregano were permitted to inform the public of their well-documented germ-killing properties. The public could take garlic or oil of oregano as prevention without risk of germ-resistance. In a country that prides itself in free speech, even the truth is being barred from public dissemination in regards to herbal antibiotics.
NATURAL ANTIBIOTICS TO THE RESCUE
Virtually every prescription antibiotic that is consumed is hastening the day when all the bug-killers will be rendered useless. Why we continue to solely rely upon patentable molecules to kill germs and ignore more potent, economical and safe natural antibiotics, which do not induce resistance, goes unexplained except for financial greed.
A growing body of scientific evidence confirms that natural herbs and spices exhibit antibiotic properties that are equivalent if not superior to drugs.
For example, researchers in the Netherlands report that garlic is capable to eradicating vancomycin-resistant enterococci bacteria, a germ that is a growing cause of mortality in hospitals.8 A broth of 2% garlic juice has been shown to completely eradicate ampicillin-resistant E. coli.9 E. coli infections are widespread, originating from fecal material, and a resistant strain of E. coli (clonal group A) is accounting for more than half of all the female urinary tract infections. In some parts of the country about 20% of these infections now only respond to a combination of powerful drugs, drugs that encourage even more drug resistant strains.10
A 1% solution of garlic from fresh cloves has been shown to have antibacterial activity against E. coli and antibiotic-resistant (methicillin) Staph aureus, Salmonella, a common cause of food poisoning, and Candida albicans, the most common yeast infection.11 Researchers at Georgetown University report that oil of oregano (not the kitchen cupboard variety of oregano) was recently tested against drug-resistant Staphylococcus bacteria and was found to be equally effective as streptomycin, penicillin and vancomycin.12
These herbal antibiotics do not induce germ resistance. The complete lack of antibiotic resistance with garlic has been repeatedly shown.13 Garlic exhibits strong activity against bacteria, even multi-drug resistant strains, as well as against fungi (yeast) and viruses.14 In one report, infectious disease specialists concede that garlic may be effective in the treatment of middle ear infection given that antibiotic drugs are failing.15
An estimated 50% of the US adult population is believed to be infected with Helicobacter pylori, the gastric bug that causes ulcers and has recently been confirmed as the germ that causes stomach cancer.16 Antibiotics could virtually eliminate the risk of stomach cancer, the 8th leading cause of cancer-related death in the US, but their use among non-ulcer infected patients would induce more drug-resistant strains of H. pylori. Yet garlic is able to kill H. pylori.17 It is unlikely that physicians will begin to advise their patients to consume more garlic or garlic capsules to prevent stomach cancer. So the public remains at risk for a form of cancer that could be virtually eliminated.
Furthermore, it is apparent that the simultaneous use of antioxidants and herbs such as green tea with antibiotic drugs may actually help to prevent genetic mutations and suppress the emergence of resistant bacteria in the first place.18
Animals could be given natural antibiotics like garlic and oil of oregano and these germ-killers can also be placed in foods to kill off any pathogens and to reduce spoilage. Oil of oregano has been shown to exhibit the greatest inhibition of bacteria among food spices in a recent test against pathogens such as E. Coli, Staph aureus, Pseudomonas and others germs.19
A study conducted at Cornell University found that spices such as garlic, oil of oregano, onion, and allspice kill every bacterium tested, even anthrax.20 A 1977 conducted in India reveals that crude garlic extract exhibited greater antibiotic action against Bacillus anthracis (anthrax) than tetracycline, penicillin, streptomycin, ampicillin, erythromycin and other antibiotics.21
In a remarkable study, the Garlic Centre in Essex, England, reports that a daily garlic capsule reduced the incidence of the common cold by 50 percent during winter months. The common cold affects more people than any other type of infection.22 There are nearly 61 million cases of the common cold annually in the US says the National Center for Health Statistics. Garlic has been shown to kill Herpes simplex, Parainfluenza, and rhinovirus in a laboratory dish.23 Researchers at the Weitzmann Institute of Science in Israel report that allicin, a component of garlic, effectively kills off multi-drug resistant strains of E. coli, fungi such as Candida albicans, protozoan parasites such as Giardia lamblia and viruses.24
SPECIAL ADDENDUM: OTHER ANTIBIOTICS WORK EQUALLY WELL AS CIPRO
While only a few hundred Americans were potentially exposed to anthrax and given precautionary courses of CIPRO and other antibiotics, the demand for CIPRO was reported to rise from less than 10,000 to over 18,000 pills dispensed daily in the week of October 14-20, 2001.
The FDA approved CIPRO for inhalational anthrax on July 28, 2000. However, it is not the only drug that works against anthrax. For ethical reasons human studies on anthrax cannot be conducted. But animal studies with anthrax were performed in 1993. Groups of 10 animals were exposed to inhalational anthrax. Each antibiotic tested completely protected the animals while on the drug, but upon discontinuance, here was the survival rate: penicillin, 7 of 10 survived; ciprofloxacin (CIPRO)*, 8 of 9 survived; doxycycline, 8 of 9 survived. (*An additional animal was not counted because it succumbed to pneumonia during the trial.)25
The director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony S. Fauci, says there is a false impression that CIPRO is the only drug that would work against anthrax. CIPRO is in a class of drugs called fluoroquinolones would work equally well, he says.26 Brand names of other fluoroquinolone drugs are Avelox, Floxin, Levaquin, Maxaquin, Noroxin, Penetrex, Tequin and Zagam.
In 1994 Russian scientists found the protective effects of three fluoroquinolone drugs, ciprofloxacin (CIPRO), pefloxacin and lomefloxacin, were practically the same against anthrax.27 Five other fluoroquinolones have been shown to be pharmaceutically superior to ciprofloxacin.28 Levofloxacin is better absorbed into lung tissue than ciprofloxacin, which is where anthrax spores reside.29
CIPRO WORSE THAN ANTHRAX
According to a Washington Post report, the use of CIPRO is likely to threaten the health of far more people than any anthrax attack. The report says 7.3 percent of CIPRO users can expect to experience side effects, which includes death following the ingestion of just one tablet, seizures, hallucinations, and rash, the latter symptom mimicking a sign of anthrax which would unnecessarily frighten a CIPRO user.30
Though CIPRO has been around since 1987 and over 250 million people have taken it, it is fraught with serious side effects, enough to make a person wonder why it was approved for use in a biological warfare environment.
First, Fluoroquinolone drugs like CIPRO are not recommended for children under the age of 18, nor pregnant females.
Second, Fluoroquinolones may adversely interact with many other drugs. Caffeine, warfarin blood thinners (Coumadin), magnesium antacids, and theophylline asthma drugs should not be taken with this class of drugs.31
Third, Ciprofloxacin and all fluoroquinolones are photosensitive medications and they can cause skin reactions upon exposure to solar ultraviolet radiation and even from low-dose fluorescent lighting.32 Phototoxicity is reported with all fluoroquinolones but lomefloxacin's molecular structure minimizes this problem.33 Rescue workers, police or military personnel who receive CIPRO-like drugs and who must work outdoors may experience light-induced reactions.
Fourth, CIPRO is reported to interfere with collagen formation and induce rupture of the Achilles tendon. Tendonitis and tendon ruptures have been reported several months following antibiotic treatment even with minimal mechanical stress.34 Even rather low doses of CIPRO-like drugs, or a magnesium-deficient diet, may induce Achilles tendon inflammation or rupture.35 Apparently CIPRO either blocks the absorption or the action of magnesium, an essential mineral, which then results in weakened joints. The provision of supplemental magnesium should be advised to users of CIPRO since this may prevent the occurrence of joint ruptures.36 But nothing is said about the connection between magnesium shortage and joint problems in product literature. Since magnesium impairs the absorption of fluoroquinolones, it should be taken in between courses of this class of antibiotics.37 CIPRO-like drugs are apparently inappropriate for use in a biological warfare environment where rescue, police and military personnel require antibiotic treatment and yet may suffer joint injuries that would impair their performance.
Fifth, Bayer AG, the German-based parent company that produces CIPRO, is accused of fraud and unethical behavior for not disclosing to surgical patients in a clinical study of the potential hazards posed by the use of CIPRO when it is taken with preoperative sedatives or tranquilizers. Apparently sedatives impair the absorption of CIPRO and then increase the risk of infection. Some British surgical patients experienced infections and one died in a clinical study that Bayer refuses to disclose data on.38 It is reported that many people in New York City began taking tranquilizers following the attack on the World Trade Center. This would be a contraindication for CIPRO-like drugs in a metropolitan biological warfare arena where some people may require surgery due to trauma, etc.
Sixth, in fact the FDA is proposing to withdraw one of the fluoroquinolone drugs used in poultry because is causes the rapid development of resistant Campylobacter bacteria that can be transferred to humans.39
Bayer sells CIPRO for $1.83 per table to the US government, less than the $4.40 normal price. But the recommended two 500 mg tablets per day for 60 days to treat inhalational anthrax exposure would cost about $220, compared to around $20 for tetracycline or doxycycline.
- White DG, et al, The isolation of antibiotic-resistant salmonella from retail ground meats, New England Journal Medicine 345: 1147-54, 2001 and Associated Press, October 18, 2001.
- Levy SB, The challenge of antibiotics resistance, Scientific American, March 1998.
- Lavin BS, Antibiotic cycling and marketing into the 21st century: a perspective from the pharmaceutical industry, Infection Control Hospital Epidemiology 21: 32-35S, 2000.
- Lewis R, The rise of antibiotic-resistant infections, FDA Consumer Magazine, Sept. 1995.
- FDA approves long-needed new antibiotic, Associated Press, Sept. 21, 1999.
- Ostrom CM, Antibiotics dangerously overused, group warns, Seattle Times, October 17, 2001.
- Acheson DWK, Foodborne diseases update: current trends in foodborne diseases, Medscape Infectious Diseases, 2001]
- Jonkers D, Sluimer J, Stobberingh E, Antibacterial effect of garlic and omeprazole on Helicobacter pylori, Antimicrobial Agents & Chemotherapy 43: 3045-54, 1999.
- Unal R, et al, Novel quantitative assays for estimating the antimicrobial activity of fresh garlic juice, Journal Food Protection 64: 189-94, 2001.
- Gewolb J, New E. coli strain causes trouble, Science Now, October 4, 2001.
- Sasaki J, et al, Antibacterial activity of garlic powder against Escherichia coli O-157, Journal Nutrition Science Vitaminology 45: 785-90, 1999.
- Preuss HG, Oregano oil may protect against drug-resistant bacteria, Georgetown Researcher Finds, Science Daily, October 11, 2001.
- Sivam GP, Protection against Helicobacter pylori and other bacterial infections by garlic, Journal Nutrition 131: 1106-08S, 2001.
- Ankri S, Mirelman D, Antimicrobial properties of allicin from garlic, Microbes Infection 1: 125-29, 1999.
- Klein JO, Management of acute otitis media in an era of increasing antibiotic resistance, International Journal Pediatric Otorhinology 5: 15-17S, 1999.
- Uemura N, et al, Helicobacteri pylori infection and the development of gastric cancer, New England Journal Medicine 345: 829-32, 2001.
- Sivam GP, Protection against Helicobacter pylori and other bacterial infections by garlic, Journal Nutrition 131: 1106-08S, 2001; Sivan GP, et al, Helicobacter pylori- in vitro susceptibility to garlic (Allium sativum) extract, Nutrition & Cancer 27: 118-21, 1997.
- Pillai SP, et al, The ability of certain antimutagenic agents to prevent development of antibiotic resistance, Mutation Research 496: 61-75, 2001.
- Elgayyar M, et al, Antimicrobial activity of essential oils from plants against selected pathogenic and saprophytic microorganisms, Journal Food Protection, 64: 1019-24, 2001.
- Billing J, Sherman PW, Antimicrobial functions of spices, Quarterly Review Biology 73: March, 1998.
- Sharma VD, et al, Antibacterial property of Allium sativum: in vivo and in vitro studies, Indian Journal Experimental Biology 15: 466-68, 1977.
- BBC News, October 3, 2001; Josling P, Preventing the common cold with a garlic-supplement: a double-blind, placebo-controlled survey, Advances in Therapy 18: 189-93, 2001.
- Weber ND, et al, In vitro virucidal effects of Allium sativum (garlic) extract and compounds, Planta Medica 58: 417-23, 1992.
- Ankri S, Mirelman D, Antimicrobial properties of allicin from garlic, Microbes Infection 1: 125-29, 1999.
- Friedlander AM, et al, Postexposure prophylaxis against experimental inhalation anthrax, Journal Infectious Diseases, 167: 1239-43, 1993.
- Kolata G, Cipro isn't the only drug that can be prescribed, anthrax experts say, New York Times, October 17, 2001.
- D'aikov SI, et al, Comparative evaluation of the effectiveness of fluoroquinolones in experimental anthrax infection, Antibiotic Khimioterapy, 39: 15-19, 1994.
- Lubasch A, et al, Comparative pharmacokinetics of ciprofloxacin, gatifloxacin, grepafloxacin, levoflaxacin, trolafloxacin and mixifloxacin after single oral administration in healthy volunteers, Antimicrobial Agents Chemotherapy 44: 2600-03, 2000.
- Gotfried MH, et al, Steady-state plasma and intrapulmonary concentrations of levofloxacin and ciprofloxacin in healthy adult subjects, Chest 119: 1114-22, 2001.
- Gillis J, Connolly C, Emphasis on Cipro worries officials, Washington Post, Oct. 19, 2001, Page A17.
- Medline Plus, Micromedex, Inc., 12/18/2000, US National Library of Medicine; Ball P, Safety of the new fluoroquinolones compared with ciprofloxacin, Journal Chemotherapy 12: 8-11, 2000.
- Jaffe A, Bush A, If you can't stand the rash, get out of the kitchen: an unusual advers reaction to ciprofloxacin, Pediatric Polmonology 28: 449-50, 1999.
- Stablmann R, Lode H, Toxicity of quinolones, Drugs 58: 37-42, 1999 supplement.
- Casparian JM, Luchi M, et al, Quinolones and tendon ruptures, Southern Medical Journal 93: 488-91, 2000.
- Shakibaei M, et al, Biochemical changes in Achilles tendon from juvenile dogs after treatment with ciprofloxacin or feeding a magnesium-deficient diet, Archives Toxicology 75: 369-74, 2001.
- Egerbacher M, et al, In vitro evidence for effects of magnesium supplementation on quinolone-treated horse and dog chondrocytes, Veterinary Pathology 38: 143-48, 2001.
- Fish DN, Chow AT, The clinical pharmacokinetics of levofloxacin, Clinical Pharmacokinetics 32: 101-19, 1997.
- Drug firm put patients at risk in hospital trials, London Times, May 14, 2000.
- FDA/CVM Proposed to withdraw poultry fluoroquinolones approval, Food & Drug Administration, October 26, 2000.
October 24, 2001