Michael's Dad's Story

 Note: This is the text of a message I posted to the Yahoo quinolones group last year, reporting the details of the death of my father, probably due to Levaquin, in December, 2002:

Last December [2002] my 86 year-old father developed what appeared to be a sinus infection, manifested mainly by bad headaches and lot of so-called post nasal drip.  He went to an ear-nose-throat specialist, who prescribed a regiment of 21 days of Levaquin, prednisone, flonase nasal spray, and a saline nasal spray.  By way of background, Dad was in full possession of his faculties, kept his own house and cooked for himself, and even drove at night with no problems.  He was bothered by gouty arthritis, moderate peripheral vascular disease in his legs, atrial fibrillation (AF), and used a pacemaker.  He took coumadin for the AF, prilosec for heartburn, celebrex for the arthritis, and had taken a diuretic for many years for hypertension.

When Dad purchased the Levaquin, the pharmacist advised him to to pick up only ten days dosage, saying that Levaquin was pretty strong stuff and that Dad might not want to take the full 21 days worth.

After the first two days on Levaquin, Dad's headaches ceased, and he felt quite good.  By the fifth day, the headaches returned, and he started to have pain across the midsection, which became severe by the seventh day.  On the eighth day, he called the prescribing doctor, who told him to stop taking the Levaquin.  The next day, the pain was so severe, I had to take him to his internist, who suspected gastritis, but also ordered an ultrasound four days hence to check the liver and gall bladder.  That night, at 3 AM, Dad called me to take him to the hospital, as the pain was unbearable.

At the emergency room, he was quickly diagnosed as having an acute gall bladder attack, and was scheduled for surgery.  BUT, preoperative testing showed an alarming rise in his liver enzymes, indicating a problem with the liver, and a multitude of tests showed no problem with the gall bladder.  A parade of specialists determined that he had a severe hepatitis, but with no sign of any infectious cause, or any signs of restricted blood supply or malignancy that might cause such a hepatitis.  Dad was admitted early on Tuesday morning, and by Thursday, his liver was in crisis (fulminant hepatic failure), with accompanying coagulation and kidney problems.  Had he been younger, he would have been a candidate for a transplant, but that was not a realistic option for an 86 year old man on coumadin.  The only hope was that the liver would purge itself of whatever toxin was destroying it, and do that before it was damaged beyond repair.  That did not happen, and by Saturday, we were on a death watch.  I should add at this point that Dad was still in severe pain and distress from the hepatitis, eased somewhat, but not completely by opiate pain medication.  By Sunday morning, he was comatose, and passed away late Sunday night.

I ordered an autopsy, which verified massive liver necrosis (i.e.-tissue destruction), consistent with drug or toxin reaction.  Further toxicology reports shed no light on the situation, and verified low Tylenol levels (Tylenol being a known cause of liver failure). 

The only major change in Dad's life prior to the liver failure was his taking the Levaquin.  He had taken prednisone several times previously, and always tolerated it well.  Dad's internist of many years is convinced that the Levaquin caused the liver failure, and has written a letter the manufacturer and the FDA stating same.  He has told me he will never prescribe Levaquin again, for any reason.  Levaquin has no significant history of causing severe liver failure that I know of, but I believe some of its analogs do have such a history.  As for myself, I will NEVER take any quinolone drug for any reason.  Ironically, my urologist recently prescribed Levaquin for me prior to a minor surgical procedure, and when I told him of my family history, he switched me over to Bactrim [to which I had a severe reaction, but that's another story] without further discussion.  If you are nervous about quinolones or any other medication, don't worry about hurting the doctor's feelings.  Speak up!

Also, if your pharmacist cautions you, as Dad's pharmacist did, don't ignore him/her.  They push a lot of pills, and probably know many horror stories, if you can get them to talk.

Michael Schwartz

Last Updated 5/06/04