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The common antibiotic that could leave you wheelchair-bound
Fluoroquinolones are amongst the most commonly-prescribed antibiotics in the UK, often dispensed for ailments ranging from urinary tract infections to respiratory issues. Prescribed regularly, they are seen by many healthcare professionals as a quick fix for a variety of bacterial infections. But for some patients, the consequences of these medications are nothing short of devastating, leaving them with lifelong disability, wheelchair-bound and, in some cases, even thoughts of suicide.
I know this first hand. I'm Nathan Kay, a journalist and editor. I've worked for publications such as The Mail on Sunday, Daily Express and CNN, covering everything from royal news to celebrity gossip. I was a regular 40-something-year-old, living in the city, healthy and active, swimming and gyming regularly, working in a high-stress job. I had a career I loved and a life I was proud of.
That was until the day I took an antibiotic that I thought was nothing more than a routine prescription – Ciprofloxacin, a common fluoroquinolone. What followed was a descent into chronic pain, brain fog, and fatigue that I couldn't shake. My life, my career and my relationships were completely altered by an antibiotic more powerful than I could ever have imagined.
I am one of the thousands affected by what's known as fluoroquinolone toxicity, or 'being floxed.' It's a term used by patients who have suffered severe, sometimes permanent side effects from these antibiotics. And it's growing. Studies show that fluoroquinolones are prescribed more than 20,000 times a month in the UK, and while the majority of people experience no lasting effects, an alarming number of others, like me, find their lives permanently altered.
A significant portion of those affected by fluoroquinolone toxicity, as many as 15 per cent (according to some estimates), experience debilitating symptoms that can persist long after the drug is discontinued, with some patients struggling to find effective treatment. The psychological toll is often ignored, yet research shows a strong correlation between fluoroquinolone use and mental health issues, including depression and suicide. GPs are essentially playing Russian roulette with patient health by prescribing these drugs without fully acknowledging or preparing patients for the life-altering risks they may face.
This article aims to highlight the growing problem, with first-hand accounts from patients whose lives have been destroyed by these antibiotics, supported by expert opinions and statistics showing just how many lives are being impacted.
The growing issue: What are fluoroquinolones?
Fluoroquinolones are a class of broad-spectrum antibiotics often used to treat a variety of bacterial infections. They include well-known medications such as Ciprofloxacin, Levofloxacin, and Moxifloxacin, and are highly effective, able to penetrate different areas of the body to fight infections in the bladder, lungs and skin, among others.
Their strength makes them invaluable for certain serious infections – but also potentially dangerous. Professor Munir Pirmohamed, 62, a consultant physician at the Royal Liverpool Hospital and leading pharmacogenetics expert at the University of Liverpool, explains: 'They interfere with the normal functioning of the bacterial cell by inhibiting two main enzymes, DNA gyrase and Topoisomerase IV. The bacteria cannot repair their DNA, and this kills the bacterial cells.'
From the start, he notes, it has been known that they can cause tendon problems, most often with the Achilles. But the damage can go further: 'There is concern about FQAD [Fluoroquinolone-Associated Disability]. In some people, FQAD represents a life-changing event. The severity, recovery and prognosis vary. There are many theories why these drugs cause the problem, including effects on mitochondria and on the immune system, but none have been proven.'
Though fluoroquinolones are prescribed regularly, the risk associated with them is often underestimated. In 2024, the MHRA (Medicines and Healthcare products Regulatory Agency) issued updated guidelines advising that these antibiotics should only be prescribed when other first-line treatments are unsuitable or ineffective. Despite this, there are still over 20,000 prescriptions written for Ciprofloxacin each month in the UK alone.
The concerns: The dark side of Fluoroquinolones
Fluoroquinolones have been linked to devastating side effects, leaving many patients disabled and in a state of constant suffering. The impact can be profound, with some experiencing chronic pain, fatigue and neurological disorders, all of which can dramatically alter quality of life. For some, the consequences are so severe that they lead to thoughts of suicide.
The concern with fluoroquinolones isn't just that they have the potential to cause discomfort – the risks can be life-altering.
For 49-year-old recruitment consultant Victoria Abotorabi from Leeds, the consequences were devastating when, in 2024, she was prescribed Ciprofloxacin with prednisolone for a suspected sinus infection.
'The out-of-hours ENT didn't make me aware of the potential side effects – neither did the pharmacy.'
Five days in she had pins and needles, and numb arms and hands. A&E checked her heart but not her medication. Two weeks later, she woke with severe head pain and pressure. Tests followed – an MRI and lumbar puncture – but still no review of her antibiotics. At one point, she recalls, 'every single muscle in my body went into spasm.'
Victoria's symptoms escalated to the point where she became housebound, and unable to work or care for her children. 'This has completely devastated my life,' she says. 'I have lost my physical and mental health. I have severe PTSD, depression, chronic pain and a diagnosis of fibromyalgia, dysautonomia, FND and digestive issues… A year later, I am still struggling.'
She has been referred to a mental health crisis team after suicidal thoughts.
'I couldn't stop crying… I was in so much pain and so scared I was dying, and no one could help me. I tried to end my life because I was in so much physical pain. I have never thought about suicide before.'
The psychiatric risks are stark. In one high-profile case, respected cardiologist Dr Robert Stevenson died by suicide shortly after starting Ciprofloxacin. A coroner concluded the drug's psychiatric effects – including depression and suicidal thoughts – contributed to his death.
The science behind the damage
Dr Richard Berwick, 36, consultant in pain medicine at the Walton Centre and a Versus Arthritis clinical training fellow at the University of Liverpool, explains one theory as to why fluoroquinolones may be particularly harmful because of their ability to damage cells at the mitochondrial level. 'During an FQ toxicity reaction, cell mitochondria (the cell powerhouse) might be disrupted, causing cells to become injured, especially nerves and muscles. They can also block nerve channels leading to altered brain function,' he explains.
This disruption can lead to long-term symptoms that continue long after the medication is stopped. As Dr Thuva Amuthan, 34, a general practitioner, further elaborates: 'Even a short course can, in rare cases, lead to long-term problems with tendons, muscles, joints, nerves and sometimes mood and memory. Early recognition of symptoms is vital.'
The people suffering from a lifelong struggle
For me, fluoroquinolone toxicity left me virtually bedridden for six months, unable to move and feeling poisoned. I've improved to about 80 per cent of my previous health, but never fully recovered. At the same time, a quad bike accident left me with multiple fractures, compounding my ongoing pain. Outwardly, I may look fine, but daily fatigue and discomfort remain constant companions.
For Myles Washington, 38, a former personal trainer from the Isle of Wight, the ordeal began at 14, when he was given a fluoroquinolone for what was likely an allergy. At 24, he was prescribed another course for a misdiagnosed condition.
'It completely destroyed my health and changed the course of my life,' he says. 'I lost my career, my dreams and my identity.'
He has since endured torn ligaments, chronic fatigue, tendon ruptures and nerve symptoms. 'This isn't just a temporary side effect,' he says. 'It's long-term, progressive damage.'
Jeremy Maddock, 57, who runs an architectural practice in Devon, was floxed after taking Ciprofloxacin for a presumed infection. The side effects left him crawling upstairs and barely able to walk. 'The pain has moved around nearly every part of my body. I suffered psychological stress and suicidal ideation way beyond the normal realms of anxiety.'
Years later he lives more normally, but must take extreme care to avoid relapse. He credits the Fluoroquinolone Toxicity Support UK Facebook group with 'probably saving lives.'
Treatment – or the lack of it
There is no standard treatment protocol for fluoroquinolone toxicity. Dr Berwick says supportive care is key, with therapies to help people live better despite symptoms. Some may use anti-neuropathic painkillers, though these bring their own side effects.
Only one specialist in England can formally diagnose the condition. Many patients, says Fluoroquinolone Toxicity Support UK Facebook group co-founder Miriam Knight, 73, are steered towards expensive, unproven alternative therapies. 'Steer very well clear,' she advises. 'There are absolutely no guarantees except that the clinic will make money.'
Professor Pirmohamed agrees, adding that: 'Many people are being offered untested and untried treatments, which can be expensive and potentially dangerous. I am not convinced there is enough evidence to recommend them.'
I've tried B12 injections and quarterly vitamin-and-magnesium IV treatments myself. They help briefly, but offer no long-term fix.
What's next? The road to change
Research is underway, but funding is scarce. Professor Pirmohamed calls for dedicated investment to define the condition, identify genetic risk factors and develop diagnostic tests and treatments – all with strong patient involvement.
I took part in the APIF study into autoimmune phenotyping in fibromyalgia, run by the University of Liverpool and The Walton Centre NHS University Hospital. Dr Berwick explains that he observed two fluoroquinolone toxicity patients in the study had temperature sensitivity, which is often seen in fibromyalgia. He noticed that the participants who develop fibromyalgia-type syndromes after fluoroquinolones report heightened cold sensitivity, and cold exposure can exacerbate pain. It's a link that suggests there could be an affected sensory-nerve or central-sensitisation pathway in fluoroquinolone toxicity patients, and researchers are now actively investigating that.
Genetics may also play a role, making some people inherently more prone to long-term reactions.
What can you do?
If prescribed a fluoroquinolone, ask about alternatives. Ensure your doctor knows of any conditions that may make you more vulnerable. When you're offered a fluoroquinolone, ask your GP whether safer first-line antibiotics are suitable – and check for red-flag risk factors if you're aged over 60, suffer from renal impairment, have been diagnosed with fibromyalgia, suffer from autoimmune diseases, have a history of tendon problems or have had an organ transplant. These groups face higher odds of serious side effects. If you take a fluoroquinolone, report any tendon pain, weakness, dizziness or mood changes immediately.
For those already affected, community support is vital. Miriam Knight's group, founded in 2015, offers a lifeline to sufferers, reassuring them they are not alone or 'going mad.' Members share advice and comfort, without giving direct medical recommendations.
