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Levofloxacin-associated Achilles tendon rupture.
A Scott Mathis1, Vicky Chan, Margaret Gryszkiewicz
1Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA. smathis@sbhcs.com
The Annals of Pharmacotherapy
|July 5, 2003
Summary
Levofloxacin may cause Achilles tendon rupture, especially in older men with risk factors like renal failure. This case highlights a possible link between the antibiotic and partial tendon tears.
Area of Science:
- Pharmacology
- Orthopedic Surgery
- Nephrology
Background:
- Fluoroquinolones, including levofloxacin, are associated with an increased risk of tendon disorders.
- Risk factors for fluoroquinolone-induced tendon rupture include advanced age, male gender, corticosteroid use, and renal impairment.
Observation:
- A 79-year-old male patient developed acute renal failure secondary to dehydration.
- The patient experienced ankle pain on the 12th day of levofloxacin treatment for presumed pneumonia.
- Magnetic resonance imaging revealed a 6-cm partial Achilles tendon tear with degenerative changes.
Findings:
- The Naranjo probability scale suggested a possible association between levofloxacin and the Achilles tendon rupture.
- The patient presented with multiple known risk factors for tendon rupture, including older age, male gender, steroid use, and acute renal failure.
Implications:
- This case underscores the potential for levofloxacin to induce Achilles tendon rupture, particularly in patients with pre-existing risk factors.
- Clinicians should exercise caution when prescribing levofloxacin to patients with risk factors for tendon injury.
- Awareness of this adverse effect is crucial for early diagnosis and management of levofloxacin-associated tendinopathy.