Alvarez Luque M Gomariz Santacecilia and Villamor Baliarda and Rando Matos and Garci'a Fernandez

aEAP Florida Nord. L'Hospitalet de Llobregat. Barcelona. Spain.

Key words: Tendinitis. Levofloxacino. Adverse effects.

Tendinitis Associated With Levofloxacin

Introduction. In the last new years have appeared quinolonas in the market with good profile of tolerance, like the levofloxacino. It is an antibiotic of ample phantom that has demonstrated to be relatively safe and with one long average life, which allows his administration once to the day.

Clinical case. One is a man of 50 years with personal antecedents of renal arterial and transplanted hypertension from 1987. It makes habitual treatment with captopril 25 mg, tacrolimus, alopurinol, prednisona 5 mg, atenolol 50 mg, ursodesoxicólico and indapamida acid. Evolution h went to the consultation by a picture of acute pain in both 24 aquíleos sinews of that made difficult the deambulación. Three days before it had gone to urgencies by a picture of fever, cough and expectoración that was oriented like respiratory infection, initiating treatment with 500 levofloxacino mg. In the exploration it presented/displayed pain to the palpación of both sinews, without flogóticos signs, and great functional impotence. With the suspicion of secondary tendinitis to treatment with quinolonas the levofloxacino by a betalactámico was replaced, indicating rest and antiinflammatory treatment. To the 3 weeks the patient refers improvement of the clinic.

Discussion and conclusions. The tendinitis is mentioned like a possible adverse effect, being considered an incidence of 1 case by 3,400 treated patients. One takes place with more frequency in men and the affection usually happens in the sinew of Aquilles of bilateral form. Almost all the communicated cases of tendinitis are related to the concomitante use of corticoids, the age outpost and the renal insufficiency. The direct toxicity on the sinew seems to be patogenia more probable and affects mainly to the sinews that support more load, like the aquíleo, the sinew of the quadriceps and the one of the sleeve of the rotadores. When it is suspected this injury is necessary to investigate on the use of quinolonas in the previous days and to suspend them immediately. The time of recovery is considered between 3 weeks to 3 months, in case that tendinosa breakage takes place. The tendinitis associated to quinolonas is described as an adverse reaction little frequents, but with the appearance of new molecules of a daily dose it has increased his use and, with it, the incidence of indirect effect. These drugs are due to avoid in old, patient with renal disease or when corticoids are taken.

Bibliographical references:

1. Hoops C, Flowers C, Mezzano S. associated aquiliana Tendinitis to the levofloxacino use: communication of four cases. Rev Med Chile. 2002; 130: 1277-81. [Medline]

2. Lewis JR, Gums JG, Dickensheets DL. Bilateral Levofloxacin-induced Achilles tendonitis. Ann Pharmacother. 33:792 - 5.

3. Courteous R, Cossío P, Miñambres and, Muñoz J. aquílea Tendinitis in the old one. Tie Primary. 2005; 35: 55. [Medline] [Article]

Tie Primary 2005; 36:286 - 287

Latin American society of Allergy, Asma and Inmunología