Association between tendon ruptures and use of fluoroquinolone, and other oral antibiotics: a 10-year retrospective study of 1 million US senior Medicare beneficiaries

Study (n=1,009,925) reports of the fluoroquinolones, only levofloxacin exhibited significant increased risk of tendon rupture (HR=1.16; 95% CI 1.06 to 1.28). Of non-fluoroquinolone antibiotics, cephalexin exhibited increased risk of tendon rupture (HR=1.31; 95% CI 1.22 to 1.41).

SPS commentary:

Authors; highlight that the fluoroquinolones as a class; were not associated with the increased risk of tendon ruptures. Neither ciprofloxacin nor moxifloxacin exhibited any risk for tendon ruptures; whereas levofloxacin did exhibit significant increased risk. Moreover, cephalexin with no reported effect on metalloprotease activity had an equal or greater risk than levofloxacin; which authors’ state pulls into question whether metalloprotease activity has any relevance to observed associations with tendon rupture.

BMJ Open