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Severe shoulder tendinopathy associated with levofloxacin
Walter de Araujo Eyer-Silva1, Henrique de Barros Pinto Netto, Jorge Francisco da Cunha Pinto
1Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro, Brazil. walter.eyer@ig.com.br
Summary
Fluoroquinolone antibiotics can cause tendon issues. A patient developed severe shoulder tendinopathy after doubling her levofloxacin dose, requiring surgery.
Area of Science:
- Pharmacology
- Orthopedic Surgery
- Infectious Diseases
Background:
- Fluoroquinolones (FQs) are broad-spectrum antibiotics.
- Tendinopathy and myopathy are known, though uncommon, side effects of FQs.
- Community-acquired pneumonia is a common indication for FQ use.
Observation:
- A 63-year-old female patient with community-acquired pneumonia was prescribed levofloxacin.
- The patient secretly doubled her prescribed levofloxacin dosage.
- She subsequently developed severe left shoulder tendinopathy.
Findings:
- The patient's tendinopathy was severe enough to necessitate surgical intervention.
- Surgical procedures included stabilization with suture anchors and subacromial decompression.
- This case highlights a potential severe adverse event linked to FQ dosage escalation.
Implications:
- Clinicians should be vigilant about potential FQ-associated tendinopathy, especially with dosage changes.
- Patient adherence to prescribed medication dosages is crucial for preventing adverse events.
- Further research may explore risk factors and management strategies for FQ-induced tendinopathy.
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