From the *Department of Internal Medicine, Ankara Diskapi Education and Research Hospital, Ankara, Turkey; †Department of Gastroenterology, Ankara Diskapi Education and Research Hospital, Ankara, Turkey; and ‡Department of Gastroenterology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey. Correspondence: Seyfettin Köklü, MD, Karargahtepe mahallesi, Kumrulu sokak, 18/1, Keçiören, Ankara, Turkey. You might not think a drug you take to treat a sinus problem or urinary-tract infection would have anything to do with your running. John Saylor had barely missed a day of running in 30 years when he learned about these complications the hard way. Food and Drug Administration issued stronger warnings about a class of antibiotics called fluoroquinolones—and side effects that could prove devastating to runners. In September 2008, at age 61, the runner from Dryden, New York, had a prostate biopsy. He took an antibiotic called Levaquin for three days afterward to prevent infection. His first run back was interrupted by pains in his calves and hamstrings so strange and severe he thought his muscles might rip off. Saylor limped a mile and a quarter home, called his urologist (who recommended ibuprofen), and looked at the antibiotic label. He noticed a warning—which had just been added that year—about the risk of tendinitis and even tendon rupture associated with the drug. What are these drugs, and why would you get a prescription? Fortunately for Saylor, a week off from running resolved the pain with no long-term effects. Fluoroquinolones are broad-spectrum antibiotics: They kill a wide range of harmful bacteria and often work against infections resistant to other drugs, said Houston Methodist primary-care sports-medicine physician Vijay Jotwani, M. Doctors frequently prescribe them for kidney infections, respiratory infections, urinary tract infections, and sinus infections.
The fluoroquinolone antibiotics are important drugs indeed – ciprofloxacin is probably the most famous of the bunch, but there’s a whole series of them, and they’re widely used for serious bacterial infections. (I last wrote about them here, with the various arguments about how they were developed in the first place). But for many years now, it’s been increasingly clear that this class of drugs can have some very unwelcome effects in some patients. The most prominent of these is tendon damage, which often showing up as problems with the Achilles tendon, up to outright rupture even months after drug treatment. Other muscle and connective tissue effects have been seen, as well as CNS effects and others. Over the years, the drugs have picked up black-box warnings for these effects, which seems entirely appropriate. Any theory has to take into account the fact that the great majority of patients seem tolerate the drugs pretty well, but that suggests that a better knowledge of the mechanism might let you pick out which people shouldn’t take them in the first place. This article at is a good summary of current research in the area. Fluoroquinolone use is associated with the development of tendinopathy, most commonly affecting the Achilles tendon. Here we present the first reported case of bilateral iliopsoas tendon rupture associated with prolonged ciprofloxacin use. This older woman presented with non-traumatic, sudden onset hip pain which was diagnosed as a right iliopsoas rupture on MRI. Despite stopping ciprofloxacin, she went on to develop rupture of the contralateral iliopsoas tendon. This case highlights the time lag between fluoroquinolone use and susceptibility to this rare but important complication. A 70-year-old woman presented with sudden onset, severe pain in her right groin on standing from a chair. She normally mobilised with a crutch and described several months of gradually worsening hip pain but no history of trauma.
Ciprofloxacin is an antibiotic used to treat a number of bacterial infections. This includes bone and joint infections, intra abdominal infections, certain type of. Ciprofloxacin Cipro, Cipro XR, Proquin XR is an antibiotic drug prescribed to treat a variety of bacterial infections sinus, tooth, UTI, gonorrhea, prostatitis.