Levofloxacin-associated Achilles tendon rupture.
OBJECTIVE
To describe a case of levofloxacin-induced partial Achilles tendon rupture; this occurred in the presence of known risk factors and acute renal failure.


METHODS
A 79-year-old white man received levofloxacin for presumed pneumonia, developed acute renal failure in the setting of dehydration, and began having ankle pain on the 12th day of admission. Levofloxacin was discontinued, and magnetic resonance imaging revealed a 6-cm partial tear and degenerative changes.


CONCLUSIONS
The Naranjo probability scale indicates a possible association between levofloxacin and tendon rupture because the event occurred in the setting of known risk factors such as steroid use, renal failure, older age, and male gender.


CONCLUSIONS
Levofloxacin, like other fluoroquinolones, may cause Achilles tendon rupture, and this may be particularly likely with known risk factors.
Mathis
A Scott
AS
Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA. smathis@sbhcs.com
Chan
Vicky
V
Gryszkiewicz
Margaret
M
Adamson
Robert T
RT
Friedman
Gary S
GS
D000125:Achilles Tendon / Q000293:injuries* / Q000473:pathology; D058186:Acute Kidney Injury / Q000150:complications; D000368:Aged; D000375:Aging / Q000502:physiology; D000890:Anti-Infective Agents / Q000009:adverse effects*; D006801:Humans; D064704:Levofloxacin; D008279:Magnetic Resonance Imaging; D008297:Male; D015242:Ofloxacin / Q000009:adverse effects*; D012307:Risk Factors; D012421:Rupture / Q000139:chemically induced / Q000473:pathology
D000890:Anti-Infective Agents; D064704:Levofloxacin; D015242:Ofloxacin