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Can Clindamycin Cause Tendon Rupture?

Posted on Tue, 17 Mar 2015

Question: have you ever heard of clindamycin causing a tendon rupture

Answered by Dr. Klarida Papaqako (52 minutes later)

Brief Answer:
No, Clindamycin does not give tendon rupture

Detailed Answer:
Hello,
Thank you for posting your question to HCM.

I read very carefully your query and checked also the interactions between the drugs.
No, tendon rupture is not one of the side effects of Clindamycin (not proven with evidences at least), and it is well combined with Flagyl.

Keep in mind though, that one of the most common and dangerous side effects is diarrhea that is watery or bloody so in this case stop using this medicine and call your doctor, because it gives life threatening intestinal problems. Your doctor have done a great job by combining it with Flagyl, because it will prevent that side effect.

Hope this is helpful.
Let me know if I can help you with any other question, otherwise please rate the answer.

Take care.
Dr. Klarida.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Klarida Papaqako (15 hours later)

Dear Dr. Papaqako: I thank you very much for your thoughtful reply. We have decided to stop the Clindamycin now that he is just about 7 weeks of antibiotic, and we will be continuing the Flagyl until next Wednesday (the first four weeks he was on oral Ceftriaxone). I wanted to know if a dose of 1000 mg Q 12 hours was felt to be adequate for osteomyelitis in a 200 pound 16 year old. I see that the recommended doses are 7.5 mg/kg q 6 hours (this would be about 2700 mg) so 1000 mg Q 12 hours is actually a little bit short of this target. Is 1000 mg q 12 hours generally considered to be adequate for osteomyelitis?
THANKS,
XXXX

Answered by Dr. Klarida Papaqako (13 hours later)

Brief Answer:
No need to worry about the dose

Detailed Answer:
Hello Dear XXXXXXX
I'm sorry to hear all that your boy has been gone through. Osteomyelitis is surely a difficult disease to treat.

Ceftriaxone is a good antibiotic to treat it, and I suppose you have decided to use that following the culture. The evidences say to continue for 4-6 weeks.
No need to worry about the dose- 1000mg * twice/day is the XXXXXXX dose. For people with weight more then 60 kg we don't calculate the dose in mg/kg. So yes, it is adequate for osteomyelitis.

I wish your boy a good healing.
Let me know if I can help with any other question. I would be happy to answer.
Take care.
Dr. Papaqako.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Klarida Papaqako (1 hour later)

HI Dr. Papaqado: Thank you for your reply. I meant to say that he was treated with Ceftriaxone IV for 27 days, but on day 12 of the treatment we identified Fusibacterium Nucleatum, so oral Flagyl 1000mg BID was initiated. Upon the completion of 27 days of Ceftriaxone, the IV was discontinued and he was started also on Clindamycin 600 mg q 8 hours so at that time he was on both Flagyl and Clindamycin. We just discontinued the Clindamycin and he is supposed to be on Flagyl until Feb 25. I was just super worried about the Flagyl dose.
THANKS,
XXXX

Answered by Dr. Klarida Papaqako (2 hours later)

Brief Answer:
Details Below

Detailed Answer:
Hello again XXXXXXX

When anaerobes become part of the pathogens like Fusibacterium, treatment of choice is clindamycin 600 mg IV every 4 hour and/or metronidazole for gram-negative anaerobes 500 mg IV every 8 hours.
This of course is what the trials say, but doctors personalize the treatment. Looks to me like metronidazole is higher dose, but if your son is well, and the 25 of Feb is near now, he should finish with those doses. Sometimes is better to raise the dose when the medicine allows a window, and in your case its oral.

Hope I answered your question.
Take care.

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Above answer was peer-reviewed by : Dr. Raju A.T