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Eur J Clin Pharmacol. 2007 May;63(5):499-503. Epub 2007 Mar 3.

Use of fluroquinolone and risk of Achilles tendon rupture: a population-based cohort study.

Author information

1
Department of Infectious Medicine, Odense University Hospital, 5000, Odense C, Denmark.

Abstract

OBJECTIVE:

Several case-control studies have reported that the use of fluoroquinolone increases the risk of rupture of the Achilles tendon. Our aim was to estimate this risk by means of a population-based cohort approach.

SETTING:

Data on Achilles tendon ruptures and fluoroquinolone use were retrieved from three population-based databases that include information on residents of Funen County (population: 470,000) in primary and secondary care during the period 1991-1999. A study cohort of all 28,262 first-time users of fluoroquinolone and all incident cases of Achilles tendon ruptures were identified.

MAIN OUTCOME MEASURES:

The incidence rate of Achilles tendon ruptures among users and non-users of fluoroquinolones and the standardised incidence rate ratio associating fluoroquinolon use with Achilles tendon rupture were the main outcome measures.

RESULTS:

Between 1991 and 2002 the incidence of Achilles tendon rupture increased from 22.1 to 32.6/100,000 person-years. Between 1991 and 1999 the incidence of fluoroquinolone users was 722/100,000 person-years, with no apparent trend over time. Within 90 days of their first use of fluoroquinolone, five individuals had a rupture of the Achilles tendon; the expected number was 1.6, yielding an age- and sex-standardised incidence ratio of 3.1 [(95% confidence interval (95%CI): 1.0-7.3). The 90-day cumulative incidence of Achilles tendon ruptures among fluoroquinolone users was 17.7/100,000 (95%CI: 5.7-41.3), which is an increase of 12.0/100,000 (95%CI: 0.0-35.6) compared to the background population.

CONCLUSION:

Fluoroquinolone use triples the risk of Achilles tendon rupture, but the incidence among users is low.

PMID:
17334751
DOI:
10.1007/s00228-007-0265-9
[Indexed for MEDLINE]

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