Which fluoroquinolone is most commonly associated with tendon rupture?

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Ciprofloxacin is the fluoroquinolone most commonly associated with tendon rupture, particularly in certain populations. This risk is particularly pronounced in older adults, individuals on concurrent corticosteroid therapy, and those with a history of tendon disorders. Research has indicated that fluoroquinolones can lead to tendinopathy, specifically affecting the Achilles tendon, leading to potential ruptures.

The specific mechanism by which ciprofloxacin contributes to tendon rupture is not entirely understood, but it is believed to involve alterations in collagen synthesis and degradation, which can weaken the tendons.

In contrast, although levofloxacin, moxifloxacin, and norfloxacin are also fluoroquinolones, their associations with tendon rupture are less prominent when compared to ciprofloxacin. Thus, when assessing the risk of tendon damage related to fluoroquinolone use, ciprofloxacin stands out as the most significantly implicated.

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