Levaquin!?

docjeter

I was prescribed a 10 day dose of Levaquin for an infection (abscess) by my PCP.  I'm worried about the risk of tendon rupture, especially with the OS training style.  Most of the studies I have reviewed regarding this medication deal and the tendon issues deal with long term use by patients over 60 (I'm 39).  Any Ortho Surgeons or PCPs care to comment?  Do I continue with Levaquin, or ask my PCP for something else?  He offered Bactrim DS as an alternative.

Carl

Andrew-

One of the most dangerous drugs we take is, Tylenol......if you take this then from time to time then you will be fine. They often tell you however not to take Levequin with:

http://www.levaquin.com/levaquin/about_levaquin_effects-levaquin.html

I do see your point....very scary ecspecially if you read through all of the stuff. I have never taken it but my wife had to for a severe sinus infection and did well with it and no side effects besides a little diarrhea.

That is just my two cents worth. I think we might have an internal Med or infectious control doc in the haus that can way in much deeper.......

docjeter

thanks carl! An ortho buddy of mine said its a good antibiotic, but be careful with heavy lifting and dynamic activities like basketball & jumps. May have to temper my run intervals a bit. Uggh. Sounds like some LSD in the mix for a bit.

jhbinsc

Yes, fluoroquinolones like Cipro, etc. can cause tendon issues. It is a very good antiobiotic but would be conservative and back off the intense running or else go w/ the Bactrim if you aren't allergic to sulfa drugs. I've seen some tendon issues w/ Levaquin/Cipro and the like in my practice and my wife has as well in her PT practice. No need to push the luck if no real need to....

GSmith821

@Andrew, not an MD but a PharmD, specifically dealing with the ICU and ID at a large teaching hospital...just so you know my credentials. Where is the abcess? Levofloxacin is probably overkill, as in too broad a spectrum, for a community-acquired abcess. There have been reports of fluoroquinolone induced tendon issues but most of the data was pre-marketing animal data and were longer term than a 10 day course. Bactrim DS is a very good alternative along with Ceftin or Augmentin (as long as you are not penicillin allergic).

rtagher

It's a good drug when needed, but would choose something else if possible. Have known patients (not mine thankfully) that have had ruptured achilles tendon after use. Some of those were taking steroids at the same time for chronic sinusisits. Would choose the Bactrim and if not responding, move onto to the fluoroquinolone.

jhbinsc

Watch out Andrew, these PharmD's can be dangerous!

J/K George works in same hospital as I do. Glad he chimed in.

docjeter

Thanks Jeff. I called my PCP and took him up on his offer to switch to the Bactrim. I was having anxiety regarding the Levaquin, and you helped push me over the edge. I appreciate it

docjeter

Thanks too Rob and George

jhbinsc

You bet. Happy to  help. Feel better ASAP!

GSmith821

One last caveat, abscesses can be caused by anaerobes, Bactrim, and for that matter Levaquin, is not very active against most anaerobes. If you are not getting better in 3-4 days or it is getting worse, contact your physician.

jhbinsc

You pharmacists always say that!

Ralph Butler

 Andrew,

Speaking as a Colon and Rectal surgeon, the treatment for an Abscess is drainage and not abx.  If its a walled off collection of pus,(abscess) and its drained you will not need abx.  If you have a soft tissue infection(cellulitis) then you would need abx.  Not sure where your problem is or how sure your PCP is thats it is an abcess or cellulitis but keep an eye on it and if its not improving in the next few days make sure you get it followed up.

Ralph