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Related Experiment Videos

Levofloxacin-induced bilateral Achilles tendonitis.

J R Lewis1, J G Gums, D L Dickensheets

  • 1College of Pharmacy, University of Florida, Gainesville, USA. lewisjr.alachua@shands.ufl.edu

The Annals of Pharmacotherapy
|August 31, 1999
PubMed
Summary

This case report details a patient experiencing bilateral Achilles tendonitis after taking levofloxacin for pneumonia. This highlights a rare but serious adverse effect of fluoroquinolone antibiotics.

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Area of Science:

  • Pharmacology
  • Orthopedics
  • Infectious Diseases

Background:

  • Fluoroquinolone antibiotics, including levofloxacin, are widely used for bacterial infections.
  • Tendon-related adverse events are known but rare complications associated with fluoroquinolone use.
  • Postmarketing surveillance is crucial for identifying rare adverse effects not detected in premarketing trials.

Observation:

  • An 83-year-old woman developed bilateral Achilles tendonitis three days into a ten-day course of levofloxacin for pneumonia.
  • Adverse effects, including nausea and dizziness, began during treatment, with tendonitis symptoms peaking four days after completion.
  • The patient showed marked improvement with conservative management (immobilizer, rest) but had not fully resolved symptoms at three weeks.

Findings:

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  • This is the first reported case of levofloxacin-induced bilateral Achilles tendonitis in the medical literature.
  • While not reported in clinical trials, postmarketing surveillance has received reports of similar adverse events to the manufacturer.
  • The temporal association suggests a possible causal link between levofloxacin and the development of tendonitis.

Implications:

  • This case underscores the importance of considering tendonitis as a potential adverse effect of levofloxacin, even in the absence of prior reports.
  • Clinicians should be vigilant for tendon-related symptoms in patients treated with levofloxacin and other fluoroquinolones.
  • Further postmarketing data is essential to clarify the true incidence and risk factors for levofloxacin-associated tendonitis and rupture.