Tendinitis and Tavanic®/Ciflox®

Question

Hello,
I'm a 33 years old CF patient.
Since August, I react to Tavanic® (levofloxacin) by tendinitis pain under the foot arch. My intravenous treatments are very infrequent (1 every 2 years).
My doctor told me that if I can not support Tavanic®, we will have to consider much more frequent intravenous treatments.
My question: is it possible to continue the Tavanic® treatment despite tendinitis if it is bearable and does not necessarily lead to rupture of a tendon?
I'm afraid a very trench response of my doctor: maybe he would not want to take any risk because I am the only patient to have these symptoms ... I would like to share experience on this point.
Thank you in advance.

Answer

Hello.

Tendinitis under fluoroquinolones contra-indicate the use of this antibiotic class (levofloxacin, ofloxacin, ciprofloxacin ... ).

In medicine, you should always think about the risk-benefit balance. From the time when other antibiotics can be used, even if they are intravenous antibiotics, the benefit is clearly in favor of those IV antibiotics.

We could discuss the reintroduction of quinolones in the situation where the quinolone antibiotic has to be used only in case of resistance to other antibiotics. Then, the respiratory benefit may be greater than the risk taken for the tendon level.

You should know that we don't find any correlation between the prescribed dose of quinolones or treatment duration and severity of tendinitis. This usually occurs in patients with renal insufficiency or glucocorticoid therapy but may also occur in the absence of associated contributory factors. The symptoms usually disappear in 1-2 months, but symptoms may persist and surgery may be necessary. Functional disability may be important and justify the advice of your doctor.

Good luck.
Cordially
Dr Isabelle Danner-Boucher

09.12.2013