Case report highlights ciprofloxacin's impact on disability and symptoms in multiple systems, suggesting significant risks.
Ciprofloxacin is among the most commonly prescribed Fluoroquinolones. Side effects of Fluoroquinolones include tendinopathies, ar-rhythmias, gastrointestinal discomfort, and neurological symptoms. The definition of a "Fluoroquinolone-associated disability" includes dis-ability, symptoms in several body systems and duration of symptoms after discontinuation of the antibiotic. The pathophysiology of this disease is probably due to a damage to the redox system. We report on a 41-year-old patient who felt pain in his Achilles tendons three days after starting to take ciprofloxacin (of a total of 3 g) and presented as an emergency. In the course of the disease, the pain became chronically disabling and the patient developed paresthesia of both extremities and intermittent heart palpitations. The only tolerated pain medication was Pregabalin. Several MRI examinations showed minimal peritendinitis and irritation of the Achilles tendons. Blood samples indicated probable intracellular damage at low intracellular ATP and coenzyme Q10 values.
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Piazza et al. (2025) studied this question.
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