The fluoroquinolone (FQ) class of antibiotics includes the world’s most prescribedantibiotics such as ciprofloxacin, levofloxacin, and ofloxacin that are known for their lowbacterial resistance. This is despite their potential to trigger severe side effects, such asmyopathy, hearing loss, tendinopathy, and tendon rupture. Thus, healthcare organizationsaround the world have recommended limiting the prescription of FQs. Tendinopathy is acommon name for maladies that cause pain and degeneration in the tendon tissue, whichcan result in tendon rupture. Whilst there are several identified effects of FQ on tendons,the exact molecular mechanisms behind FQ-mediated tendon rupture are unclear. Previousresearch studies indicated that FQ-mediated tendinopathy and tendon rupture can beinduced by changes in gene expression, metabolism, and function of tendon resident cells,thus leading to alterations in the extracellular matrix. Hence, this review begins with anupdate on FQs, their mode of action, and their known side effects, as well as summaryinformation on tendon tissue structure and cellular content. Next, how FQs affect thetendon tissue and trigger tendinopathy and tendon rupture is explored in detail. Lastly,possible preventative measures and promising areas for future research are also discussed.Specifically, follow-up studies should focus on understanding the FQ-mediated tendonchanges in a more complex manner and integrating in vitro with in vivo models. Withrespect to in vitro systems, the field should move towards three-dimensional models thatreflect the cellular diversity found in the tissue.

Duman, E., Müller-Deubert, S., Pattappa, G., Stratos, I., Sieber, S. A., Clausen-Schaumann, H., Sarafian, V., Shukunami, C., Rudert, M. & Docheva, D. “Fluoroquinolone-Mediated Tendinopathy and Tendon Rupture”, Pharmaceuticals

Link: https://doi.org/10.3390/ph18020184

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