Musculoskeletal Complications of Fluoroquinolones: Guidelines and Precautions for Usage in the Athletic Population

Mederic M. Hall, Jonathan T. Finnoff, Jay Smith

Research output: Contribution to journalArticlepeer-review

39 Scopus citations

Abstract

Fluoroquinolone antibiotics are associated with a wide spectrum of musculoskeletal complications that involve not only tendon but also cartilage, bone, and muscle. Insights into the pathoetiology of fluoroquinolone toxicity on musculoskeletal tissues have been evolving over recent years. Although the pathoetiology is certainly multifactorial, alterations in cell signaling proteins and direct toxic effects on musculoskeletal tissues have been strongly implicated. Increasing age and concomitant systemic corticosteroid use appear to significantly increase the risk of adverse events. The purpose of this article is to review the musculoskeletal complications associated with use of fluoroquinolone antibiotics by adults; identify risk factors associated with fluoroquinolone toxicity; explore the possible pathoetiology of fluoroquinolone toxicity on tendon, cartilage, bone, and muscle; and offer recommendations regarding evaluation and treatment of fluoroquinolone-associated musculoskeletal complications. In addition, this review will provide recommendations regarding fluoroquinolone use in athletes and return to play after fluoroquinolone exposure.

Original languageEnglish (US)
Pages (from-to)132-142
Number of pages11
JournalPM and R
Volume3
Issue number2
DOIs
StatePublished - Feb 2011

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Neurology
  • Clinical Neurology

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