Fluoroquinolones-induced tendinitis and tendon rupture in kidney transplant recipients: 2 cases and a review of the literature

Fluoroquinolones are an important class of synthetic antibiotics and their use recently expanded with a new activity against Gram positive and anaerobics. In the literature many side effects were documented and, among them, tendinitis and subsequent tendon rupture are important causes of morbidity. The incidence is 0.14% to 0.4% but, in the kidney recipient population, the phenomenon is even more common (incidence, 12.2%-15.6%). Advanced age seems to be the most significant risk factor. Long period of hemodialysis, diabetes mellitus, hyperparathyroidism, rheumatic diseases, gout, and corticosteroids are the other predisposing factors in kidney recipients, even if they are still under discussion. All of these risk factors can create a synergistic toxicity or at least an additive effect. A case of tendinitis and a case of bilateral Achilles tendon ruptures in 2 kidney recipients are described and a brief discussion of the literature is presented.