The family of surfing legend Bob Davie speak to The New Zealand Herald about the adverse effects of the medication he was prescribed. / Alan Gibson
It started with a buzzing in his head.
Then came the tremors, nausea, chronic pain in his neck and shoulder. He struggled to sleep and snapped his achilles tendon.
Bob Davie, who started the first commercial surfboard factory in NEw Zealand and is often recognised as one of the fathers of the Kiwi surf culture, knew something wasn't right.
During the next few years Davie, a fit and healthy man in his 60s, meticulously documented his symptoms.
He travelled from his home in Whangamata to Hamilton and then up to Auckland for appointments with neurologists, radiologists and GPs to find out what was wrong.
Davie had CT scans, MRIs and other tests but doctors struggled to find a reason for his health problems.
After researching his symptoms online Davie became convinced he was suffering from side effects of a common antibiotic, Ciprofloxacin.
In December 2011, a Hamilton general and respiratory physician told him she too believed this was the cause of his ill health.
Bob Davie in his surfing heyday. Photo / Supplied
Ciprofloxacin is a type of fluoroquinolone antibiotic which can be used to kill a wide range of bacteria and is often prescribed for severe urinary tract or prostate infections.
Fluoroquinolones, including Ciprofloxacin, have been linked to nerve damage and tendon ruptures that have caused permanent disability, as well as depression and anxiety.
The drugs were dispensed from community pharmacies across the country more than 1.8 million times in the past decade - which has concerned microbiologists and others in the medical field.
They are becoming less effective on the bacterium that causes gonorrhoea, which is becoming more resistant to antibiotics and, therefore, harder to treat.
A 2016 analysis of the World Health Organization's adverse drug reactions database found strong evidence that taking fluoroquinolones increased a person's risk of suicidal behaviour.
Between 2009 and 2011 Davie had been prescribed at least seven courses of Ciprofloxacin to treat a bad prostate infection.
"I feel that on the whole his symptoms of tremor, agitation and insomnia could be side effects of Ciprofloxacin," said one of Davie's doctor in referral letter sighted by the Weekend Herald.
On February 28, 2017, Bob Davie took his own life. He was 74.
In a note he left his children Davie described his nearly decade-long struggle with his "antibiotic episode".
"Finally enough's enough, I can't live the life I want to when I'm feeling like s*** most of the time," he wrote.
Daniel Davie (left) and Vicki Hallett, in Bob Davie's boardmaking room at his Whangamata property. Photo / Alan Gibson
Davie was remembered as a surfing legend and formidable board maker in Whangamata, Gisborne and Mt Maunganui, where he lived before moving to the Waikato beach town with his young family in 1978.
He was health conscious - a vegetarian who took up paddle-boarding after retiring and still surfed on occasion.
The much-loved father of three and grandfather of seven lived on a property on a hill lined with organic fruit trees just off Whangamata's main street with his partner of 18 years, Vicki Hallett.
Davie was sceptical of modern medicine but took Ciprofloxacin as instructed by his doctors because he was told it was the only way to clear his prostate infection, Hallett told the Weekend Herald.
"It did fix the infection but it also took my partner's life," she said.
Davie's son Daniel Davie also believes the Ciprofloxacin his dad was taking caused his death.
"From that he just went down hill. A bubbly, life loving, fishing guy, surfing now and again, paddle-boarding - it just ruined him," he said.
"He was an outgoing person but the head tremors he was sort of embarrassed about it so he kind of reclused a little.
"To see Dad like that was super-hard. It just wore him down. Someone who was so active and had no money worries should be enjoying the later years of his life and his grandkids and he's unable to do stuff."
Surfing legend Bob Davie at home near Whangamata. Photo / Supplied
The family is speaking out about Davie's death to warn other New Zealanders about the potential side effects of fluoroquinolones, which they claim Davie was not told about until after he had been taking Ciprofloxacin for the best part of two years.
"The big thing my dad would want is for people to be made fully aware that it's a pretty dangerous drug," said Daniel Davie.
"It's not going to bring him back but [if] it could save someone else going down that track it has to be done."
They are also calling for fluoroquinolones to be banned in New Zealand.
"If there's a chance that by prescribing that drug it's going to cause the pain that we've gone through, I don't think that it should be on the market," said Daniel Davie.
Hallett said Ciprofloxacin needed to be pulled from shelves as soon as possible.
"Once your nerves are damaged there's no repair so it then plays with the person's mind. They get depressed. They feel there's no happiness anymore. That quality of life has been taken."
The US medication regulatory body, the Food and Drug Administration (FDA), has repeatedly warned about the serious "disabling and potentially permanent side effects" linked to fluoroquinolones.
While they were appropriate for use against some serious bacterial infections, the risk generally outweighed the benefits of using fluoroquinolones to treat other illnesses -including acute sinusitis and uncomplicated urinary tract infections (UTIs) - the FDA said in 2016.
The agency has since put labels on fluoroquinolone boxes warning of the potential disabling side effects.
Kiwi surfing legend Bob Davie catching a wave. Photo / Supplied by Davie family
Health Canada is also introducing warning labels on fluoroquinolones.
The New Zealand Centre for Adverse Reaction Monitoring (CARM) received 445 reports of suspected negative reactions to fluoroquinolones between 2007 and last year. That included 64 cases of tendinitis and 24 tendon ruptures.
New Zealand's medicine regulator Medsafe says these figures are in line with other medications and serious reactions to fluoroquinolones are rare, effecting less than 1 in 1000 patients.
According to a report presented to the Medicines Adverse Reactions Committee last December four of the 445 reports of side effects to fluoroquinolones resulted in long-term disability.
During the first three months of this year a 60-year-old woman reported to CARM having paranoid thoughts and being anxious and agitated one day after taking Ciprofloxacin.
Between July 2005 and June 2017 ACC received 295 treatment injury claims relating to fluoroquinolone antibiotics. Of those 96 were for tendon injuries. In total, ACC paid out $255,801 in treatment injury claims related to fluoroquinolones.
ACC spokesman James Funnell said tendon ruptures related to fluoroquinolones were under-reported.
"Many tendon ruptures (especially achilles) will be lodged as normal injuries, without reference to medications. Only spontaneous ruptures (rupture without effort) are likely to be identified as a treatment injury."
Functional nutritionist Gary Moller usually works with high performance athletes, helping them achieve their best physical performance using science, but during the last decade at least 10 New Zealanders - from athletes to tradespeople - have sought his help to manage what he believes are serious side effects to fluoroquinolones.
Bob Davie outside his workshop. Photo / Craig Levers
"The only thing we seem to be able to do is manage the symptoms such as the pain and the disability," he said.
"That's what I think was the most disheartening thing is it appeared that most of the damage is permanent or at least it was going to be with somebody for decades."
Moller, who was ACC's National Co-ordinator of Sport and Recreation Safety for five years, told the Weekend Herald many of his clients' doctors had not warned them about the potential side effects of fluoroquinolones.
"That's not good enough. In my view that's negligent behaviour. No health professional should be dispensing any kind of product without being fully conversant with both the benefits and the harms."
Although the drugs' manufacturers also had a responsibility to appropriately inform doctors and consumers about potential side effects of fluoroquinolones Moller believed regulators needed to do more to ensure informed consent.
"Ultimately it's the Ministry of Health that has to act on these things because while you may have your GP and so on wanting to restrict these things to a large degree they're stuck because they don't have many options," he said.
"The authorities have to take action and they should be taking action now. In my view this drug needs to be taken off the market."
He believed fluoroquinolones should only be used to save a patient's life when no other treatment option was available.
Doctors say they rely on Medsafe to tell them whether the antibiotics are safe but Medsafe says though it sends doctors newsletters with important updates on drug safety, it's up to drug companies and doctors themselves to educate medical professionals.
Dr Tim Malloy, president of the Royal New Zealand College of General Practitioners, was not available for an interview but said in a statement that GPs relied on Medsafe to provide assurances about the safety of medicines.
"The College is not aware of any change in the availability or the safety warnings relating to [fluoroquinolones]," he said.
"All drugs come with side effects and GPs do their best to discuss these with their patients, often providing supplementary hand out material for the patient to take away."
The supplier of Ciprofloxacin in New Zealand did not respond to requests for comment about the safety of its product.
Medsafe's group manager Chris James said it published a quarterly Prescriber Update newsletter to provided doctors with the latest information about the safety of medicines.
"It's the responsibility of healthcare professionals to ensure they remain up-to-date regarding the benefits and risks of medicines."
The benefits of using a fluoroquinolone to treat a serious infection outweighed the risks of harm but doctors should discuss the risk and benefits with patients or their relatives before prescribing them, he said.
New Zealand and international guidelines state fluoroquionolones should rarely be the first medication prescribed for an infection and should only be used once other treatments had been tried and failed.
Legislation prevented Medsafe from forcing drug companies to put black box warning labels on their products but sometimes manufacturers would choose to do this, James said.
At a meeting in December the Medicines Adverse Reactions Committee recommended suppliers of fluoroquinolones update documents for doctors and consumers to include information about the potential risk of disabling side effects.
Medsafe had notified all companies marketing fluoroquinolones in New Zealand of the recommendations and the suppliers were in the process of updating their information.
It also included the recommendations in its March 2018 Prescriber Update.
But for Davie's family, it's too little too late.
"Once your life's gone, you're gone. There's no coming back," said Hallett.
Where to get help:
• Lifeline: 0800 543 354 (available 24/7) • Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7) • Youth services: (06) 3555 906 • Youthline: 0800 376 633 • Kidsline: 0800 543 754 (available 24/7) • Whatsup: 0800 942 8787 (1pm to 11pm) • Depression helpline: 0800 111 757 (available 24/7) • Rainbow Youth: (09) 376 4155 • CASPER Suicide Prevention If it is an emergency and you feel like you or someone else is at risk, call 111.
