Author: Don Stader, MD
- Fluoroquinolones can cause connective tissue disruption leading not only to tendon rupture but also aortic dissection.
- Retrospective study from Taiwan showed over a 2x higher rate of dissection when exposed to fluoroquinolones (1.6% vs 0.6%).
- Remember to think about aortic dissection when you have a patient with chest pain that travels and/or involves neurologic symptoms.
- Try to use fluoroquinolones when no other appropriate antibiotic exists as they have significant other side effects as well.
Editor’s note: In July 2018, the FDA required strengthening of warning labels on fluoroquinolones about the risks of mental health effects and hypoglycemia
Lee CC, Lee MG, Hsieh R, Porta L, Lee WC, Lee SH, Chang SS. Oral Fluoroquinolone and the Risk of Aortic Dissection. J Am Coll Cardiol. 2018 Sep 18;72(12):1369-1378. doi: 10.1016/j.jacc.2018.06.067. PubMed PMID: 30213330.
Khaliq Y, Zhanel GG. Fluoroquinolone-associated tendinopathy: a critical review of the literature. Clin Infect Dis. 2003 Jun 1;36(11):1404-10. Epub 2003 May 20. Review. PubMed PMID: 12766835.
Summary by Travis Barlock, MS4 | Edited by Erik Verzemnieks, MD