A 55-year-old man started a new oral antibiotic 2 weeks ago for a chest infection and now presents with bilateral posterior heel pain and swelling with morning stiffness. He takes a statin and has no history of trauma. Which drug class is the most likely cause of his bilateral Achilles tendinopathy?
- A Statins
- B Fluoroquinolones ✓
- C Macrolides
- D Thiazide diuretics
Correct answer: B. Fluoroquinolones
Explanation
Fluoroquinolones such as ciprofloxacin are well documented to cause tendinopathy and tendon rupture, with the Achilles tendon most commonly affected, often bilaterally and within days to weeks of starting the drug; the mechanism involves impaired tenocyte matrix synthesis. Statins cause myopathy affecting muscles rather than isolated tendon degeneration. Macrolides and thiazides are not associated with Achilles tendon injury.
Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.