Increased risk of achilles tendon rupture with quinolone antibacterial use, especially in elderly patients taking oral corticosteroids
- PMID:12912715
- DOI: 10.1001/archinte.163.15.1801
Increased risk of achilles tendon rupture with quinolone antibacterial use, especially in elderly patients taking oral corticosteroids
Abstract
Background: In several case reports, the occurrence of Achilles tendon rupture has been attributed to the use of quinolones, but the epidemiologic evidence for this association is scanty.
Methods: We conducted a population-based case-control study in the General Practice Research Database in the United Kingdom during the period 1988 through 1998. Cases were defined as all persons who had a first-time recording of an Achilles tendon rupture, and who had at least 18 months of valid history before the index date. As a control group, we randomly sampled 50 000 patients with at least 18 months of valid history who were assigned a random date as index date.
Results: We identified 1367 cases that met the inclusion criteria. The adjusted odds ratio (OR) for Achilles tendon rupture was 4.3 (95% confidence interval [CI], 2.4-7.8) for current exposure to quinolones, 2.4 (95% CI, 1.5-3.7) for recent exposure, and 1.4 (95% CI, 0.9-2.1) for past exposure. The OR of Achilles tendon rupture was 6.4 (95% CI, 3.0-13.7) in patients aged 60 to 79 years and 20.4 (95% CI, 4.6-90.1) in patients aged 80 years or older. In persons aged 60 years and older, the OR was 28.4 (95% CI, 7.0-115.3) for current exposure to ofloxacin, while the ORs were 3.6 (95% CI, 1.4-9.1) and 14.2 (95% CI, 1.6-128.6) for ciprofloxacin and norfloxacin, respectively. Approximately 2% to 6% of all Achilles tendon ruptures in people older than 60 years can be attributed to quinolones.
Conclusions: Current exposure to quinolones increased the risk of Achilles tendon rupture. The risk is highest among elderly patients who were concomitantly treated with corticosteroids.
Comment in
- Role of steroids in tendon rupture or disintegration known for decades.Fisher P.Fisher P.Arch Intern Med. 2004 Mar 22;164(6):678. doi: 10.1001/archinte.164.6.678-a.Arch Intern Med. 2004.PMID:15037501No abstract available.
Similar articles
- Quinolones and tendon ruptures.Casparian JM, Luchi M, Moffat RE, Hinthorn D.Casparian JM, et al.South Med J. 2000 May;93(5):488-91.South Med J. 2000.PMID:10832946Review.
- Tendinitis: the Achilles heel of quinolones!Shortt P, Wilson R, Erskine I.Shortt P, et al.Emerg Med J. 2006 Dec;23(12):e63. doi: 10.1136/emj.2006.035832.Emerg Med J. 2006.PMID:17130584Free PMC article.
- Management of bilateral Achilles tendon rupture associated with ciprofloxacin: a review and case presentation.Akali AU, Niranjan NS.Akali AU, et al.J Plast Reconstr Aesthet Surg. 2008 Jul;61(7):830-4. doi: 10.1016/j.bjps.2006.08.005. Epub 2007 Apr 3.J Plast Reconstr Aesthet Surg. 2008.PMID:17409040Review.
- Evidence of tendinitis provoked by fluoroquinolone treatment: a case-control study.Corrao G, Zambon A, Bertù L, Mauri A, Paleari V, Rossi C, Venegoni M.Corrao G, et al.Drug Saf. 2006;29(10):889-96. doi: 10.2165/00002018-200629100-00006.Drug Saf. 2006.PMID:16970512
- Achilles tendon rupture and its association with fluoroquinolone antibiotics and other potential risk factors in a managed care population.Seeger JD, West WA, Fife D, Noel GJ, Johnson LN, Walker AM.Seeger JD, et al.Pharmacoepidemiol Drug Saf. 2006 Nov;15(11):784-92. doi: 10.1002/pds.1214.Pharmacoepidemiol Drug Saf. 2006.PMID:16456878
Cited by
- COVID-19 and corticosteroids: a narrative review.El-Saber Batiha G, Al-Gareeb AI, Saad HM, Al-Kuraishy HM.El-Saber Batiha G, et al.Inflammopharmacology. 2022 Aug;30(4):1189-1205. doi: 10.1007/s10787-022-00987-z. Epub 2022 May 13.Inflammopharmacology. 2022.PMID:35562628Free PMC article.Review.
- Involvement of Bacteria in the Pathological Changes Before Achilles Tendon Rupture: A Case Series Investigating 16S rDNA in 20 Consecutive Ruptures.Cramer A, Moser C, Fritz BG, Hölmich P, Barfod KW.Cramer A, et al.Orthop J Sports Med. 2022 Aug 12;10(8):23259671221112138. doi: 10.1177/23259671221112138. eCollection 2022 Aug.Orthop J Sports Med. 2022.PMID:35982829Free PMC article.
- Benefits and risks of therapeutic alternatives for macrolide resistant Mycoplasma pneumoniae pneumonia in children.Yang HJ.Yang HJ.Korean J Pediatr. 2019 Jun;62(6):199-205. doi: 10.3345/kjp.2018.07367. Epub 2019 Mar 15.Korean J Pediatr. 2019.PMID:30999732Free PMC article.
- Association Between Third-Generation Fluoroquinolones and Achilles Tendon Rupture: A Self-Controlled Case Series Analysis.Chinen T, Sasabuchi Y, Matsui H, Yasunaga H.Chinen T, et al.Ann Fam Med. 2021 May-Jun;19(3):212-216. doi: 10.1370/afm.2673.Ann Fam Med. 2021.PMID:34180840Free PMC article.
- Incidence of postoperative wound infections after open tendo Achilles repairs.Marican MM, Fook-Chong SM, Rikhraj IS.Marican MM, et al.Singapore Med J. 2015 Oct;56(10):549-54. doi: 10.11622/smedj.2015150.Singapore Med J. 2015.PMID:26512146Free PMC article.
MeSH terms
Substances
Related information
LinkOut - more resources
Full Text Sources
Medical
Research Materials
Miscellaneous