Long term outcome after Fluoroquinolones tendinopathies
13/01/2004

14:11:07 P-0077
C Guy (1); Y Murat (1); MN Beyens (1); M Ratrema (1); G Mounier (1); M Ollagnier (1); (1) Centre de Pharmacovigilance, Hôpital Bellevue - CHU St-Etienne, Sant-Etienne

Introduction

Tendinopathies under treatment with Fluoroquinolones (FQ) are well-known side effects. Outcome is mainly favorable but, in some cases, tendinopathies can evoluate slowly or may deteriorate with after-effects.

The aim of this study is to describe the long term outcome of a series of cases.

Methods

The study was based on 38 cases of FQ tendinopathies notified to St Etienne Pharmacovigilance Center from 1992 to 2002.

Both the patients and their physicians were asked to give informations on the long term evolution of their tendinopathies. All FQ treatment were stopped one year or more before inquiry.

Results

38 observations were notified, out of which 36 were retained., concerning 21 men and 15 women. Mean age of the patients, at the moment of the adverse effect was around 57 [21-84]. 36% had an oral corticosteroid treatment associated. The FQ were: ofloxacin (13), pefloxacin (8), norfloxacin(7), levofloxacin(4), ciprofloxacin(3), lomefloxacin(1). 78% of the cases has been revealed during treatment and 22% from day 2 to 5 months after treatment. Achille tendon was injured in 80% and in 50% , there were bilateral Achille tendinitis; 3 ruptures were identified.

The evolution has shown a complete recovery in 28 cases [from 15 days to 8 months]; in 7 cases, there were after-effects: induration or nodule; pain at rest, at palpation or under activity; inability to run, to stand on toes; limping; calf amyotrophy; difficulties to shoe oneself. In 1 case, outcome was unknown.

The initial seriousness and the diagnostic delay were risk factors for sequelae.

Conclusion

The severity of this pathology and its important consequences in terms of morbidity should make the prescribing physicians consider the benefit/ratio of these antibiotics. Also, information must be given to patients in order to suspend treatment as early as possible in case of onset of tendinopathies signs.