Case reportManagement of bilateral Achilles tendon rupture associated with ciprofloxacin: A review and case presentation
Section snippets
Case report
A 62-year old man with known asthma and mild chronic obstructive airway disease (COAD) of ten years duration was prescribed a one-week course of Ciprofloxacin, 250 mg twice daily by his General Practitioner (GP) for lower respiratory tract infection. His regular medication consisted of Salbutamol and Beclomethasone inhalers and oral Prednisolone 10 mg daily. While undertaking some maintenance work at home on the sixth day, he felt a sudden pain and snap in his calf and developed a limp with
Discussion
Since the first report of the association of Fluoroquinolone and tendon disorders in 1983 a causal relationship has emerged between these antibiotics and tendon ruptures from comparative studies5, 6 and a temporal relationship often exists between the intake of FQ and the occurrence of tendon disorders in reported cases. The ratio of tendinitis to rupture is 3:17 while another study reported revealed a rate of 2.4 and 1.2 respectively per 10 000 patients.5 Although over 95% cases of tendinitis
Acknowledgments
We would like to acknowledge the contribution of Mr TL Thomas, Consultant Orthopaedic Surgeon, Colchester General Hospital, Colchester, Essex, UK who played an integral part in the management of the patient.
References (27)
- et al.
The effect of ciprofloxacin on tendon, paratenon and capsular fibroblast metabolism
Am J Sports Med
(2000) Therapie
(1996)- et al.
Norfloxacin induced rheumatic disease (Letter)
N Z Med J
(1983) - et al.
Levofloxacin-associated Achilles tendon rupture and tendinopathy
Scand J Infect Dis
(2003) - et al.
A comparison of ciprofloxacin, norfloxacin, oxfloxacin, azithromycin and cefixime examined by observational cohort studies
Br J Clin Pharmacol
(1996) - et al.
Achilles tendonitis associated with fluoroquinolones
Br J Clin Pharmacol
(1999) - et al.
Features of tendon disorders with fluoroquinolones
Therapie
(1994) - et al.
Quinolones and tendon ruptures
South Med J
(2000) - et al.
Tendon disorders attributable to fluoroquinolones: a study on 42 spontaneous reports in the period 1988 to 1998
Arthritis Care Res
(2001) - et al.
Achilles tendon rupture and Fluoroquinolones use: report of two cases
Arch Med Res
(1997)
Seven Achilles tendonitis including three complicated by rupture during fluoroquinolone therapy
J Rheumatol
Pathology of the Achilles tendon in association with ciprofloxacin treatment
Foot Ankle Int
Fluoroquinolone therapy and Achilles tendon rupture
J Am Podiatr Med Assoc
Cited by (41)
The use of host factors in microbial forensics
2019, Microbial ForensicsGait instability and bilateral heel pain
2018, FMC Formacion Medica Continuada en Atencion PrimariaFluoroquinolones and the Risk of Achilles Tendon Disorders: Update on a Neglected Complication
2018, UrologyCitation Excerpt :The incidence of FQ-associated tendinopathy or tendon rupture in an otherwise healthy population is rarely reported and is estimated to be 0.14%-0.4%.6,22 The mean age of patients with FQ-associated tendinopathy is 64 years old, with a male-to-female ratio of 2:1 and bilateral involvement in 27% of cases.30 van der Linden et al6 calculated the excess risk of FQ-associated tendinopathy at 2.9 per 1000 prescriptions.
Bilateral spontaneous atraumatic rupture of the Achilles tendon in an athlete
2016, American Journal of Emergency MedicineStatus and headway of the clinical application of artificial ligaments
2015, Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and TechnologyCitation Excerpt :In addition, the Leeds–Keio ligament also served well in clinic work.29–37 Although primarily designed for ACL reconstruction, the Leeds–Keio ligament were generally adopted in various conditions, such as rotator cuff tear,36 knee extensor mechanism failure,7 Achilles tendon rupture,38 iliofemoral ligament deficiency,34 and even ankle lateral ligament rupture.31 In all these cases, the outcomes were satisfactory.