Response to article by van der Linden et al

doi:10.1136/bmjusa.02110004

BMJ, doi: 10.1136/bmjusa.02110004, (Published 20 February 2003)

Letters

From BMJ USA 2002;Nov:614

EDITOR $---$ I have to disagree with the conclusion of the study by van der Linden et al [Fluoroquinolones and risk of Achillestendon disorders: case control study. BMJ USA, August 2002, p437] that the risk of Achilles tendon disorders is increased amongpatients taking fluoroquinolones. As the paper stated, the increasein risk was small $---$ only 3.2 excess cases per 1000 patient-years $---$ andwas observed only among patients age 60 and older. A better controlgroup would have been persons who had taken a different antibioticfor an illness or disease. Illnesses are commonly known to inhibitthe recuperative and reparative processes within the body, andillnesses are also associated with decreased physical activity.Decreased physical activity, in turn, compromises the structuralintegrity of the musculoskeletal system. Illnesses are more likelyto decrease physical activity in the elderly. The study designwas thus inadequate to determine whether fluoroquinolones or illnessis responsible for increased Achilles tendondisorders.

George Kiracofe, family physician.
Mizell Memorial Hospital, Ozark, Alabama gkiracofe1{at}yahoo.com