Fluoroquinolone-induced arthralgia and myalgia in the treatment of sinusitis.
BACKGROUND
Because of their broad-spectrum coverage, fluoroquinolone antibiotics are widely used in the treatment of acute sinusitis and acute exacerbations of chronic sinusitis. Generally, they are well tolerated, and adverse effects are usually mild. In our experience with quinolones, patients have frequently complained of arthralgias and/or myalgias. Although tendon rupture has been described as one of the more severe side effects, there are few published reports of arthralgias and/or myalgias associated with these drugs.


METHODS
A retrospective review of fluoroquinolone prescriptions in a tertiary rhinology clinic was completed. Patients treated with oral levofloxacin for sinusitis over a 12-month period were contacted by mail and asked to complete an anonymous survey regarding adverse effects. Of 81 patients identified, 36 responses were received.


RESULTS
Among respondents, the incidence of arthralgias and/or myalgias was 25%, which was more than twice the incidence of any other adverse effect reported. Occurrence of arthralgias and/or myalgias did not appear to be influenced by respondent age, course length, concurrent use of oral steroids, or a history of arthritis. Among those reporting arthralgia or myalgia, symptoms began after an average of 3 days of therapy and resolved an average of 7.5 days after cessation of treatment. Fourteen percent of respondents were unable to complete their course of therapy because of arthralgias and/or myalgias.


CONCLUSIONS
Although effective and generally well tolerated in the treatment of sinusitis, fluoroquinolone antibiotics may produce adverse effects of arthralgia and/or myalgia.
O-Lee
Tsungju
T
Division of Otolaryngology-Head and Neck Surgery, Loma Linda University School of Medicine, Loma Linda, California, USA.
Stewart
Charles E
CE
Seery
Loren
L
Church
Christopher A
CA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D018771:Arthralgia / Q000139:chemically induced*; D004334:Drug Administration Schedule; D005260:Female; D006306:Health Surveys; D006801:Humans; D064704:Levofloxacin; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000139:chemically induced*; D015242:Ofloxacin / Q000009:adverse effects* / Q000627:therapeutic use*; D012189:Retrospective Studies; D012852:Sinusitis / Q000188:drug therapy*; D013256:Steroids / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D013256:Steroids; D064704:Levofloxacin; D015242:Ofloxacin