Author:  Don Stader, MD Educational Pearls:   Fluoroquinolones can cause connective tissue disruption leading not only to tendon rupture but also aortic dissection Retrospective study from Taiwan showed over a 2x higher rate of dissection when exposed to fluoroquinolones (1.6% vs 0.6%) Remember to think about aortic dissection when you have a patient with chest pain that travels and/or involves neurologic symptoms Try to use fluoroquinolones when no other appropriate antibiotic exists as they have significant other side effects as well   Editor’s note:  In July 2018, the FDA required strengthening of warning labels on fluoroquinolones about the risks of mental health effects and hypoglycemia References: Lee CC, Lee MG, Hsieh R, Porta L, Lee WC, Lee SH, Chang SS. Oral Fluoroquinolone and the Risk of Aortic Dissection. J Am Coll Cardiol. 2018 Sep 18;72(12):1369-1378. doi: 10.1016/j.jacc.2018.06.067. PubMed PMID: 30213330. Khaliq Y, Zhanel GG. Fluoroquinolone-associated tendinopathy: a critical review of the literature. Clin Infect Dis. 2003 Jun 1;36(11):1404-10. Epub 2003 May 20. Review. PubMed PMID: 12766835. https://www.fda.gov/downloads/Drugs/DrugSafety/UCM612834.pdf   Summary by Travis Barlock, MS4    |   Edited by Erik Verzemnieks, MD