Which antibiotic class is associated with tendon rupture and should be used with caution in elderly patients?

• A. Beta-lactams
• B. Macrolides
• C. Aminoglycosides
• D. Fluoroquinolones

Answer: (D)

Tendon injury is a known adverse effect linked to an antibiotic class, and the risk is amplified in older adults. This class is the one most strongly associated with tendinopathy and tendon rupture. They can affect collagen and tendon integrity, so in elderly patients—especially those with other risk factors like corticosteroid use or kidney disease—caution is advised.

Because of this risk, use this class only when other options won’t work, and monitor for tendon-related symptoms such as sudden tendon pain, swelling, or inability to move a joint, particularly in the Achilles area. If symptoms appear, discontinue promptly and seek medical advice. In many cases, safer alternatives should be considered for elderly patients when appropriate.