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Murine Flexor Tendon Injury and Repair Surgery
Published on: September 19, 2016
Musculoskeletal injury associated with fluoroquinolone antibiotics
Yasmin Khaliq1, George G Zhanel
1Department of Pharmacy, Ottawa Hospital General Campus, Ottawa, Ontario K1H 8L6, Canada.
Abstract:
With the expanded use of fluoroquinolones and increasing number of reports of tendon injury linked to these agents, clinicians must be aware of the frequency and strength of this association. In the past, pefloxacin and ciprofloxacin were most frequently implicated, but tendon injury is reported with most fluoroquinolones. As many as half of patients with fluoroquinolone-associated tendinopathy experience tendon rupture, and almost one third have received long-term corticosteroids. Tendon injury is mostly reported in the lower extremities, but injury in the upper extremities, including the hand, has also been reported. Management is similar regardless of the location of the injury. Use of fluoroquinolones requires careful patient assessment and follow-up in view of this complication with potential for sequelae.
Insights
Fluoroquinolone antibiotics can cause serious tendon injuries, including rupture, in patients. Clinicians should carefully assess patients and monitor for this risk, especially those on corticosteroids.
Area of Science:
- Pharmacology
- Orthopedics
- Drug Safety
Background:
- Fluoroquinolone antibiotics are widely used.
- Tendon injuries are an increasingly reported adverse effect.
- Previous concerns focused on specific fluoroquinolones, but the risk is broader.
Purpose of the Study:
- To inform clinicians about the association between fluoroquinolones and tendon injury.
- To highlight the frequency and severity of fluoroquinolone-associated tendinopathy.
- To review the clinical presentation and management of fluoroquinolone-induced tendon complications.
Main Methods:
- Review of existing literature and case reports on fluoroquinolone-associated tendon injuries.
- Analysis of the spectrum of fluoroquinolones implicated.
- Examination of patient factors and injury characteristics.
Main Results:
- Tendon injury is linked to most fluoroquinolones, not just older agents like pefloxacin and ciprofloxacin.
- Up to 50% of patients with fluoroquinolone tendinopathy may experience tendon rupture.
- Nearly one-third of affected patients were on long-term corticosteroids.
- Injuries commonly affect lower extremities but can occur in upper extremities, including the hand.
Conclusions:
- Fluoroquinolone use necessitates vigilant patient assessment and monitoring for tendon injury.
- The risk of tendon rupture and other complications is significant.
- Management strategies are consistent across different injury locations.
- Awareness of this potential sequela is crucial for patient safety.
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