Antibiotics and athletic injury--warning.

A certain class of antibiotics called fluoroquinolones has long been associated with serious tendon injuries. Recent research linked the drug to over 100 cases of injuries to the tendons of the heel, quadriceps, and rotator cuffs. All active people should forego training until the effects of the drug have passed, or ask their doctor to consider a substitute antibiotic.

The most commonly prescribed of this class of drugs is Ciprofloxacin, known as Cipro. It is routinely prescribed for upper respiratory, intestinal, and urinary tract infections. Tendinopathies are chemically induced by the antibiotic and appear usually as tendinitis toward the end or shortly after the course of antibiotics is completed. Tendinitis can lead to ruptures, especially in athletic individuals involved in high-impact activities like weight lifting, sprinting, or jumping.

If you need antibiotics for an infection, discuss your treatment with your doctor. Certain infections are difficult to treat and doctors are most comfortable prescribing the best drug for the job, which might in fact be a fluoroquinolone. Be prepared to lay off your training during the course of antibiotics and for a week or so after.

(Drug Safety, 1999, Vol. 21, No. 5, pp. 407-421; Foot and Ankle International, 1996, Vol. 17, No. 8, pp. 496-498; New England Journal of Medicine, 1994, Vol. 331, pp. 748; 1995, Vol. 332, pp. 193)