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Can The Antibiotics Vancomycin And Ciprofloxacin Cause Swelling And Joints Pain?
Question: My wife is on iv antibiotics vancomycin and ciprofloxacin for 2 serious infections. Cultures reportedly show these are best among several for these infections. Clearly she needs the antibiotics. However, since starting them 4 days ago she has developed MAJOR joint pain throughout her body (she screams when being turned or when a joint is moved/ straightened) and MAJOR swelling of each arm as new ivs have had to be started moving the meds from one to the other arm (hospital id bracelets have had to be cut off and replaced twice since starting the meds). Neither were issues before start of these 2 antibiotics. What is likelihood swelling and/or joint pain is result of one/both of the antibiotics? Should I insist meds be changed and swelling & pain addressed?
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Brief Answer:
Kindly describe the details of her illness. C/S report.
Detailed Answer:
Hi,
Thank you for your query.
1. You have not mentioned any details of her infections, her current condition or the detailed culture sensitivity reports on which the current antibiotics are based. Does she have any history of joint injury or surgery in the past? Has she received these antibiotics in the past?
2. The points to be differentiated are if she has developed any septic arthritis or septicemia. As far as the antibiotics are concerned, Ciprofloxacin is more likely to be the cause than Vancomycin.
3. Your physicians will have to evaluate the risk/benefit ratio. Other fluoroquinolone group antibiotics or a different class of antibiotics can be tried if the culture sensitivity report permits.
4. A central iv line will be better if multiple iv lines have been tried.
5. If her condition does not allow the antibiotics to be changed, iv painkillers, anti-inflammatory agents or a fentanyl patch will help ease her pains.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Kindly describe the details of her illness. C/S report.
Detailed Answer:
Hi,
Thank you for your query.
1. You have not mentioned any details of her infections, her current condition or the detailed culture sensitivity reports on which the current antibiotics are based. Does she have any history of joint injury or surgery in the past? Has she received these antibiotics in the past?
2. The points to be differentiated are if she has developed any septic arthritis or septicemia. As far as the antibiotics are concerned, Ciprofloxacin is more likely to be the cause than Vancomycin.
3. Your physicians will have to evaluate the risk/benefit ratio. Other fluoroquinolone group antibiotics or a different class of antibiotics can be tried if the culture sensitivity report permits.
4. A central iv line will be better if multiple iv lines have been tried.
5. If her condition does not allow the antibiotics to be changed, iv painkillers, anti-inflammatory agents or a fentanyl patch will help ease her pains.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for the prompt reply. I will try to answer your questions.
The infections are a UTI and an infected PICC lin & site. She has taken the cipro before (several years ago) but not the vancomycin.
She has no history of joint problems or surgery.
She has history of major septic UTIs for previous 16 years as result of complications from Normal Pressure Hydrocephalus (NPH) from closed head injury. She has programmable VP shunt from 2001, replaced in 2008, regularly maintained by neurosurgeon. UTIs were reduced substantially in 2007 (from 6+ septic infections a year 1999 to 2007; to less than 1 every 3.5 to 4 years now) with bacti-guard silver coated supra pubic, last changed 12 days ago (normally changed every 21 days).
She is totally bed bound, living at home with home nursing and a full time aide. She has had major bed sores, now under control with minor wounds on a great toe and heel. It is being seen and treated regularly at local wound care center.
She has had PICC line (infected line above), removed 8 days ago. Replacement was tried twice and failed end of last week. Portacath (?) was tabled until infection is cleared. Main line was discussed but not pursued, not sure why.
She has numerous (!!) drug and food allergies. Can send list if helpful. Also can send full list of diagnosis and surgery of last 15 years if helpful. Let me know if wanted. She is type 2 diabetic.
Will forward details on infections and susceptibilities as soon as I receive them.
G Gibson, husband
The infections are a UTI and an infected PICC lin & site. She has taken the cipro before (several years ago) but not the vancomycin.
She has no history of joint problems or surgery.
She has history of major septic UTIs for previous 16 years as result of complications from Normal Pressure Hydrocephalus (NPH) from closed head injury. She has programmable VP shunt from 2001, replaced in 2008, regularly maintained by neurosurgeon. UTIs were reduced substantially in 2007 (from 6+ septic infections a year 1999 to 2007; to less than 1 every 3.5 to 4 years now) with bacti-guard silver coated supra pubic, last changed 12 days ago (normally changed every 21 days).
She is totally bed bound, living at home with home nursing and a full time aide. She has had major bed sores, now under control with minor wounds on a great toe and heel. It is being seen and treated regularly at local wound care center.
She has had PICC line (infected line above), removed 8 days ago. Replacement was tried twice and failed end of last week. Portacath (?) was tabled until infection is cleared. Main line was discussed but not pursued, not sure why.
She has numerous (!!) drug and food allergies. Can send list if helpful. Also can send full list of diagnosis and surgery of last 15 years if helpful. Let me know if wanted. She is type 2 diabetic.
Will forward details on infections and susceptibilities as soon as I receive them.
G Gibson, husband
Brief Answer:
Biofilm formation. Imaging and examination of joints. Avoid allergens.
Detailed Answer:
Hi,
Thank you for writing back.
1. While the culture sensitivity reports are awaited, you can read up about 'biofilm' formation. This is probably the reason for the resistant UTIs.
2. Request imaging of the painful joints and get an orthopedic opinion on the state of the joints.
3. The best way is to avoid those foodstuffs and drugs that she is allergic to.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Biofilm formation. Imaging and examination of joints. Avoid allergens.
Detailed Answer:
Hi,
Thank you for writing back.
1. While the culture sensitivity reports are awaited, you can read up about 'biofilm' formation. This is probably the reason for the resistant UTIs.
2. Request imaging of the painful joints and get an orthopedic opinion on the state of the joints.
3. The best way is to avoid those foodstuffs and drugs that she is allergic to.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
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Above answer was peer-reviewed by :
Dr. Shanthi.E
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