Posts: 2638
Joined: August 25, 2000
From: NY
Status: offline
Hello, A collegue has a patient that had post quad, patella pain after taking the antibiotic, cipro. Pt's MD told him to wait a few months for this to resolve but it didn't. No significant ROM or strenght limitation but pain at rest and at times with activities. How common is this and what can be done about it?
Posts: 1242
Joined: January 25, 2003
From: Indianapolis
Status: offline
Well, the quinolone class is reported to delay healing of tendons and ligaments and was shown to affect the growth of pediatric patients. Quinolones have been reported in many cases of Achilles Tendon ruptures as well.
While I know of no known case of patellar tendon rupture or quad tendon rupture, it may potentially effect these areas as well.
I personally have never had a case of this.
What is there to do? Well, I really doubt there is much to do unfortunately. This could be a microscopic tissue injury.
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Dr. Wagner DO Moderator of Medical Complexity Forum
Patients taking oral fluoroquinolones are at increased risk for retinal detachment, according to a case-control study in JAMA.
Using Canadian healthcare databases, researchers examined the records of patients who visited an ophthalmologist over 7 years. Of these patients, 4400 who were treated for retinal detachment were matched to 44,000 controls. Those with retinal detachment were more likely to be currently using fluoroquinolones than were controls (3.3% vs. 0.6%; adjusted rate ratio, 4.50). The mean time from a fluoroquinolone prescription being filled to retinal detachment was 5 days.
The authors speculate that the antibiotics may damage the vitreous and vitreous cortex; previous studies have shown that fluoroquinolones can break down collagen and connective tissue.
The authors say that although the absolute risk is low, fluoroquinolones could account for an estimated 1400 cases of retinal detachment annually in the U.S.