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SPECIAL ARTICLES: Antimicrobial Drug Reviews

FLUOROQUINOLONES AND RISK OF ACHILLES TENDON DISORDERS: CASE-CONTROL STUDY

Infectious Diseases in Clinical Practice: March 2002 - Volume 11 - Issue 3 - p 186
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FLUOROQUINOLONES AND RISK OF ACHILLES TENDON DISORDERS: CASE-CONTROL STUDY

[van der Linden PD et al. BMJ 2002;324:1306]:

This is a study of Achilles tendon disorders from a large UK general practice database including 46,776 with fluoroquinolone exposures compared to 10,000 randomly selected control patients. Among the 46,776 fluoroquinolone users, 704 had Achilles tendonitis and 38 (0.1%) had Achilles tendon rupture. The mean age was 56 years. The greatest risk for tendon rupture was age over 60 years and concurrent use of corticosteroids. The authors conclude that this adverse effect is relatively rare with an excess risk of 3.2 cases per 1,000 patient-years.

Comment:

Tendon rupture has long been recognized as an adverse effect of fluoroquinolones, although the mechanism is unclear and the data are almost entirely anecdotal. This report represents the largest systematic evaluation, confirms the low incidence, and adds age over 60 years plus corticosteroids as major risk factors.

© 2002 Lippincott Williams & Wilkins, Inc.