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[Worried89]

Hello. I developed an ear infection over the weekend and my doctor wants to put me on Z-PAC (Azithromycin) in the event that it's bacterial and not viral. I've read about horror stories on these forums regarding antibiotics like Levofloxacin, Cipro, and other drugs in the fluoroquinolones family, with documented side effects related to tendon and tissue injury.

However, I wanted to know if the very common Z-PAC has ever been associated with Peyronie's Disease, as I'm quite nervous about risking my Peyronies Disease getting worse (I'm currently on Pentox, Cialis, and CoQ10 for treatment). Any help or info would be greatly appreciated.

[TonySa]

Not that I’ve heard of, but if concerned I’d check w the doc AND a good pharmacist.  If not this antibiotic, which would they recommend or can it resolve on it’s own?

[Worried89]

I'm not sure; I can ask. I'm just posting this because of the well-known impact of fluoroquinolones that have been clearly connected to Peyronie's Disease. I simply wasn't sure if other antibiotic families have also been implicated in it.

[skunkworks]

To be completely honest, you probably know more about antibiotics and Peyronie's than your doctor and any pharmacist you might encounter. I have read an insane amount of studies on Peyronie's and anything even semi related re fibrosis or auto immmune conditions, thousands of papers, and I had not heard about fluoroquinolones having a solid connection to Peyronie's.

That said, Azithromycin usage is incredibly widespread. As I recall it is second only to Amoxicillin with regards to how often it is prescribed so if there was any connection at all to Peyronie's it would have been noticed by now just due to the sheer volume of usage.

[Worried89]

You make a good point. I'm surprised you haven't heard anything about the fluoroquinolones though; if you search the forums you'll find many posts about it.

Unfortunately the pain was so bad that I was switched to another antibiotic in the Tetracycline family called Doxycycline, which also seems to be a very commonly given antibiotic. I know this may garner a similar response to the Zithromax, but is there any info on Doxycycline and Peyronie's? This godforsaken disease has made me paranoid about every drug I put into my body for fear of making it worse.

[suicidecomingsoon]

Take your antibiotics

[Whyisthishappening]

i was yesterday on DD forum lots of people compleining about FQ and DD onset

maybe those not genetically  predisposed in concern

 Nonantibiotic Effects of Fluoroquinolones in Mammalian Cells*

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4571980/

"These results suggest, for the first time, that FQ treatment can cause unanticipated epigenetic effects. Moreover, we suggest that the well established linkage between FQ treatment and tendinopathy reflects impairment of collagen maturation by FQ"

"Tendinopathies represent distinctive and peculiar side effects of FQ antibiotics (71,–73). This collagen pathology has been considered mysterious. Some studies have suggested extracellular matrix irregularities result from FQ enhancement of protease activities (23,–25, 74, 75). Here, we suggest a different mechanism. FQs are potent iron chelators capable of inhibiting 2-KG-dependent dioxygenases because of the crucial role of iron in the active site."

    "We show that FQ treatment inhibits collagen maturation. Prolyl 4-hydroxylase and lysyl hydroxylase are iron-dependent enzymes essential for the post-translational modification of collagen. Both play central roles in collagen maturation through hydroxylation of proline and lysine residues to mediate collagen cross-linking. Covalent cross-links are required for the TENSILE STRENGHT of COLLAGEN fibers"

"FQs are able to chelate multiple divalent and trivalent metals (37), but the demonstration that EPIGENETIC EFFECTS are at least PARTIALLY REVERSIBLE by EXOGENOUS IRON suggests that iron chelation is a primary mechanism of inhibition. Moreover, transcript analysis of P4HA1 and LH1 shows clear repression upon FQ treatment suggesting additional mechanisms involved in collagen weakening"

 "suppression of HIF-1α can have drastic EFFECTS on vascularization and energy metabolism in CONNECTIVE TISSUES, contributing to decreased blood flow in an already hypoxic and avascular tissue"

."We further show that both JMHD and TET dioxygenases are inhibited by FQ treatment in cultured cells, causing histone and DNA HYPERMETHYLATION. This conclusion is further confirmed by the observation that supplemental iron prevents histone and DNA hypermethylation by FQ treatment. This is the first study to show GLOBAL EPIGENETIC CHANGES INDUCED  by FQ antibiotics."

[Whyisthishappening]

Effect of Diabetes on the Pharmacokinetic Profile of Fluoroquinolones
http://ijmpnet.com/journals/ijmp/Vol_6_No_2_December_2018/4.pdf
Effect of fluoroquinolones on mitochondrial function in pancreatic beta cells
https://www.sciencedirect.com/science/article/pii/S0928098713004508
Fluoroquinolone antibiotics and type 2 diabetes mellitus
https://www.sciencedirect.com/science/article/pii/S0306987714002175?via%3Dihub

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