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Fluoroquinolones and risk of Achilles tendon disorders: case-control study

BMJ 2002; 324 doi: (Published 01 June 2002) Cite this as: BMJ 2002;324:1306

Rapid Response:

Tendinopathy by Quinolones

The quinolone related tendinopathy is an uncommon side effect of this
family of drugs, that generally implies the withdrawal of the quinolone
and not giving any other drug of this kind because it high frequency of
class effect of this collateral effect. Although the most common place of
presentation is the Aquilles tendon, it may be located in other places
(1). In this basis, the incidence of the total percentage of the quinolone
tendinopathies may be higher than the regitered in the study. By the other
way, it would be of great interest knowing if any kind of quinolone was
specially related to the incidence of tendinopathy because in a recent
study carried out, Ofloxacin was found to be the most common quinolone
associated with tendinopathy(2) and was also related to the most severe
presentation of the condition. Although the physiopathology of the side
effect is not known, it seems to be an inflammatory response. In that
basis, we treated a patient with colchicine in a n=1 randomized controlled
trial with successs (3). Finally, we would like to add that despite the
class effect of this drugs, the new quinolones, like Levofloxacin and
Moxifloxacin, seems not to have this characteristic (3), that would allow
the clinician giving this kind of drugs if necessary.
1.Casparian JM, Luchi M, Moffat RE, Hinthorn D. Quinolones and tendon
ruptures. South Med J 2000;93:488-491.
2.Van der Linden PD, Van de Lei J, Nab HW, Knol A, Striker BH. Achilles
tendinitis associated with fluorquinolones. Br J Pharmacol 1999;48:433-7.
3. Rodriguez-Vera FJ,Pereira Vega A, Pujol de la Llave E. Tendinopathy by
quinolones: treatment and class effect in two new cases. Rev Clin Esp (in

Competing interests: No competing interests

03 June 2002
Javier Rodriguez-Vera
Hospital do Barlavento Algarvio. Sitio do Poço Seco 8500. Portimao. Portugal