Sergio Jr. had been sick the last days with some stomach problems and apparently under the race stress he ended up after his Pursuit race with a high fever caused by what was diagnosed as a gastrointestinal bacterial infection. He was prescribed Ciprofloxacin and Paracetamol.
I know that there are several medical doctors in this forum that can give me a serious opinion about the implications of this antibiotic for a road cyclist.
Should he resume training normally after a few days?
I was on it with no problems. I did ask my MD friends and they indicated it really wasn’t an issue.
As a coach I would really recommend against resuming normal training just a few days after being diagnosed with something like this. Give it some time to really heal up before drilling it in training again. That’s a great way to ride yourself in to something else.
hell be fine. the risk of tendonitis is for the age population of 60+ with rheumatoid arthritis
The reported risk is very small.
But I’ve bumped into a number of people, many decades younger than 60 and with no history of arthritis, that developed tendon issues during or shortly after taking Cipro.
It is certainly possible that their tendon issues were just coincidental, and certainly the people who have no issues don’t generally talk about that.
The only tendon issues I’ve ever had was while taking Cipro, in my case my achilles - doc took a look and advised against me taking Cipro again except in a life-threatening situation (I don’t have any risk factors either).
I wonder if the risk assessment is accurate, or my luck is that strange …
I had some Cipro and experienced an achilles injury after taking it. I was 45 at the time and actively training. I was prescribed levoquin about a year later and refused to take it. Bactrim did the trick. Google Cipro and you’ll hear stories of ruptured tendons in people much younger than those “supposedly” at risk.
Often the docs are prescribing what the reps suggest they prescribe.
During and after a few weeks in Asia I used Cipro. Upon returning to the USA and continuing to use Cipro for another week, no issues. I was running and keeping extremely late hours while over there and I had no side effects from the Cipro. I returned to cycling and running gradually after a good 2 days of sleep. Within a week I was back to normal volume and intensity.
I wonder if the increased level of stress that a high performance athlete exerts in his tendons puts him at a greater risk.
The ST population is very small compared to the whole USA and it seems that several members of ST have experienced a tendon problem caused by Cipro. It does not looks good at all.
At this point it seems to me that the risk is higher in dedicated or high performance athletes than in normal persons.
I will try to contact the MD that treated Sergio. I am pretty sure he is the MD of the National Sports Commission so he should know about that. Sergio had a very high fever so maybe he opted to using a high generation quinolone instead of the other usual antibiotics. Anyway, it seems that there are enough triathletes here with ruptured tendons after taking Cipro to be extra careful.
Although rare in the literature, it does seem (at least anecdotally) to be a higher incidence in elite athletes (hence the number of issues on ST). I have personally only seen 3 (but for what infections I treat, I rarely use a quinolone abx, and when I do, they are far from “athletic” and usually diabetic).
Infection of what type? Anaerobes? H Pylori? E-coli?..
I wish I could know.
It is probably the type you get when you cross the south fence Francois.
Before the last races started he was already with some sympthoms and I guess the TT and Road Race took a toll on his immune system. When he raced the Pursuit to qualify he was already on the brink and that night he fell really ill with a 40°C fever.
I knew something was wrong when I noticed that he was getting out of the velodrome very frequently to go to the WC and during the warmup he drank four bottles of Pedialyte. I gestured to him from the bleachers why so much liquids but he said it was Ok. I guess he did not want us to worry.
At this time he is feeling nausea but I think it might be the antibotic. As soon as he gets back to Monterrey (where they have great MDs) from the Oly Nationals I will tell him to go and do a full check.
If I recall correctly this is the first time he gets gastrointestinal sickness in at least five years. That is quite a feat living in Mexico. No more street tacos for him for a while. He was lucky he was still able to race the last important TT and RR of the Jr. Mexican season. This might be a bottle sharing incident… Another lesson learned.
Weird choice…they didn’t say if they were gram positive or negative or anything? For a younger adult without a life threatening condition amoxicillin is usually recommended without a specific bacteria in mind if you need a broad spectrum antibiotics.
Weird choice…they didn’t say if they were gram positive or negative or anything? For a younger adult without a life threatening condition amoxicillin is usually recommended without a specific bacteria in mind if you need a broad spectrum antibiotics.
not for gastroenteritis that is presumed food poisoning. cipro first line - however for traveler’s I often give it large single dose with Immodium.
Stool culturing is rarely done in Mexico before prescribing antibiotics. I have had long discussions with MD’s down here about that. The just pull out a cannon instead of the sniper rifle and get done with it.
It seems logical that elite ahtletes are at a greater risk of damage tendon damage when treated with quinolones. Tendons would be the weak link if the muscles and bones remain intact after the antibiotic treatment.
Thanks to all for your comments, particulary those of the MDs in this thread.
Sergio Jr. had been sick the last days with some stomach problems and apparently under the race stress he ended up after his Pursuit race with a high fever caused by what was diagnosed as a gastrointestinal bacterial infection. He was prescribed Ciprofloxacin and Paracetamol.
I know that there are several medical doctors in this forum that can give me a serious opinion about the implications of this antibiotic for a road cyclist.
Should he resume training normally after a few days?
Thanks beforehand,
Sergio
Sergio,
From personal experience, do not let Sergio Jr. take Cipro unless it’s absolutely required for the type of infection. It’s nasty stuff to be on, and in my case made me feel completely horrible (joint and muscle aches, etc.)…and even after stopping taking Cipro, it took a LONG time before I felt somewhat “normal”.
Look it up, Cipro is nasty stuff. In my non-medical opinion it should be reserved for the types of infections that truly require it.
Sergio Jr. had been sick the last days with some stomach problems and apparently under the race stress he ended up after his Pursuit race with a high fever caused by what was diagnosed as a gastrointestinal bacterial infection. He was prescribed Ciprofloxacin and Paracetamol.
I know that there are several medical doctors in this forum that can give me a serious opinion about the implications of this antibiotic for a road cyclist.
Should he resume training normally after a few days?
Thanks beforehand,
Sergio
Sergio,
From personal experience, do not let Sergio Jr. take Cipro unless it’s absolutely required for the type of infection. It’s nasty stuff to be on, and in my case made me feel completely horrible (joint and muscle aches, etc.)…and even after stopping taking Cipro, it took a LONG time before I felt somewhat “normal”.
Look it up, Cipro is nasty stuff. In my non-medical opinion it should be reserved for the types of infections that truly require it.
Just my 2 centavos,
Tom
He ran out of batteries on his phone but the last thing he told me is that another MD (from the Sports Commission I suppose) at the Oly Nats told him to stop the Cipro treatment. He told me he felt nauseated already. I hope it was not too late as had already taken 4 or 6 tablets.
As soon as he gets back to Monterrey he will undergo a series of tests to check out everything and give him proper antibiotics if still needed. I guess he has been under a lot stress because he raced a lot of important races in the last two months. Fortunately all went good for him. Kind of disappointed in the Pursuit even if he clocked a 3:23 3k when he felt he could do at least a 3:20 but I guess that would have been just the cherry on top of a very nice cake.
I found some very important advice here. Thanks to all for your help.
I only took one full day of Levaquin and days later my right elbow inner tendon got inflamed and never did heal until surgery 20 weeks ago. Maybe it was just overuse but I wish I had never put that antibiotic in my system.
Given it’s a ‘suspected’ bacterial gastroenteritis, the reality is that the doctor probably doesn’t know
(without stool culture) if it’s a norovirus, salmonella, giardia, etc. Cipro for a young athlete is just
not a good idea when weighing in the side effects.
Given it’s a ‘suspected’ bacterial gastroenteritis, the reality is that the doctor probably doesn’t know
(without stool culture) if it’s a norovirus, salmonella, giardia, etc. Cipro for a young athlete is just
not a good idea when weighing in the side effects.
totally agree - I don’t use it in athletes - but docs who are treating gastroenteritis (without consideration of athleticism) will use cipro first line - and one of the most common ‘traveler’s diarrhea’ cocktails is Immodium plus cipro 750mg single dose.