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Commonly Prescribed Antibiotic May Cause Peripheral Neuropathy

If you have ever taken the prescription antibiotic metronidazole (often sold as Flagyl), you could be at risk for a potentially fatal side effect called peripheral neuropathy, according to the findings of a new study in the medical journal Clinical Pharmacist.

Commonly used to treat severe infections such as bacterial vaginosis, trichomoniasis, pelvic inflammatory disease and endocarditis, as well as skin conditions like rosacea, metronidazole is generally well tolerated during initial treatment, with common side effects including nausea, lack of appetite, dysgeusia (metallic taste in the mouth) and headaches.

But following a review of 54 relevant studies, researchers found that when prescribed in high doses or over extended periods, metronidazole also carried a risk of peripheral neuropathy in patients. Peripheral neuropathy – or the damage of the peripheral nerves – can cause sufferers to experience a variety of painful symptoms in the hands and feet, including the loss of feeling, burning or tingling, and general pain.

"According to the study, not only is it possible for patients to experience peripheral neuropathy during their course of metronidazole treatment, but it's possible for that peripheral neuropathy to become permanent," says Dr. Nathan Weller, a peripheral neuropathy specialist practicing in Scottsdale, Arizona.

But preventing that peripheral neuropathy from becoming a permanent pain in the hands and feet requires some quick action on the part of patients and doctors, says Weller.

"What they found was that when patients ceased their use of metronidazole or reduced their dosage, the peripheral neuropathy symptoms went away," Weller says. "But when those symptoms were ignored, they often became permanent."

As it currently stands, drug indications caution against using metronidazole for more than 12 weeks, but the authors of the study recommend cutting this back to four weeks. They also recommend practitioners attempt to weigh the risks of an extended course of the antibiotics with the benefits, and patients should be both monitored closely and educated about the risks of the drug, should they experience peripheral neuropathy symptoms during use. The study authors also strongly cautioned against patients with peripheral neuropathy taking metronidazole at all.

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Tuesday, 23 April 2019

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