Today marks day 11 since I was diagnosed with pneumonia – though, in retrospect, the symptoms had been blossoming for a bit longer even.

That said, after I failed the first antibiotic we tried, I was given Levaquin, a stronger antibiotic – but one that can have an ugly side effect profile, including tendon rupture. While I was aware of the black box warning, we had to try something since I couldn’t breathe. What I didn’t know was that there is a significantly increased risk of this side effect occurring in people who are on long-term steroid therapy.

I probably still wouldn’t know this, except that yesterday, I started having nasty leg pain after only my third dose – an indication trouble could be brewing – and stopped it, waiting to see what I am to take in its place.

To my horror, when I began researching, I came across a piece on PubMed from the National Library of Medicine entitled, “Levofloxacin-induced Achilles Tendonitis in a Steroid User,” and, in reading it, learned, “Drug-induced tendinitis is commonly associated with fluoroquinolones, statins, glucocorticoids, and aromatase inhibitors (1). Although isolated prednisolone use is a risk factor for tendinopathy through antimitosis and collagenase activation, the combination of prednisolone and fluoroquinolones is 17.5 times more likely to cause tendinopathy than prednisolone used alone (2). Furthermore, fluoroquinolone-induced tendinopathy typically affects the Achilles tendons within two weeks of fluoroquinolone use, regardless of the class and dosages (1). Clinicians should therefore consider the risk of fluoroquinolone-associated tendinopathy, especially in steroid users.”

Yes, the combination of prednisone therapy and Levaquin makes this complication 17.5 times more likely to occur – and I’m also on a statin drug, mentioned here as well.

There are many cases of tendon rupture and patients describing their Achilles as “snapping” as they are just standing, often occurring in both legs. Yes, I am done with this medication.

Here is the PubMed article if you are interested in reading further:

pubmed levaquin journal article link.

(Of note, I did not receive a call back from the doctor’s office today – despite repeated assurances that I would – to get this sorted. So, one whole day with no antibiotics on board.)

Of course, as I wait, I am still doing (inhaled steroid) breathing treatments and taking oral steroids – so that I might eat our entire house from the combined steroid load I am working with now.

For tonight, I am waiting for the doctor in the morning and also feeling a significant weather system that will come in a few hours deep in my joints – as well as this Levaquin problem. I am exhausted and on an erratic sleep schedule too – so this is just a party all around. 😉

Still, it’s almost Banned Book Friday so Henry and I will probably be sharing a second post shortly, doing some reading, and staying cozy as we nebulize our way to new antibiotic therapy.

As always, onward. ❤

Be well, everybody. Take care of yourselves and each other.

Grace and Blessings.