Which drug class places a person at high risk for Achilles tendon injury?

Which drug class places a person at high risk for Achilles tendon injury?

• A. Fluoroquinolones
• B. Macrolides
• C. Penicillins
• D. Tetracyclines

Answer: (A)

Fluoroquinolones are linked to tendinopathy and Achilles tendon rupture. The risk arises because these antibiotics can disrupt tendon collagen synthesis and promote tendon degeneration, likely through effects on matrix metalloproteinases and tenocyte health. This tends to show up as sudden heel or calf pain, swelling, or difficulty walking after starting the drug, and the problem can progress to rupture if not stopped promptly. The danger is higher in older individuals and those on corticosteroids, making early recognition important. If tendon pain or rupture is suspected, stop the fluoroquinolone right away and immobilize the leg, seeking urgent evaluation by a clinician. An alternative antibiotic should be used if another agent is appropriate for the infection. The other common antibiotic classes listed are not as strongly associated with Achilles tendon injury, so they don’t carry the same level of risk for this specific adverse effect.

Fluoroquinolones are linked to tendinopathy and Achilles tendon rupture. The risk arises because these antibiotics can disrupt tendon collagen synthesis and promote tendon degeneration, likely through effects on matrix metalloproteinases and tenocyte health. This tends to show up as sudden heel or calf pain, swelling, or difficulty walking after starting the drug, and the problem can progress to rupture if not stopped promptly. The danger is higher in older individuals and those on corticosteroids, making early recognition important.

If tendon pain or rupture is suspected, stop the fluoroquinolone right away and immobilize the leg, seeking urgent evaluation by a clinician. An alternative antibiotic should be used if another agent is appropriate for the infection.

The other common antibiotic classes listed are not as strongly associated with Achilles tendon injury, so they don’t carry the same level of risk for this specific adverse effect.