Hi Docs. Last year I suffered a quad tendon rupture while squatting. Left me a little gun shy. Last week, I was placed on Cephalexin 250mg for a five day course because of an infected thumb from a splinter. This didn’t take care of the infection, and right now I’m on Doxycycline. I feel good, back to training, but yesterday, between sets, I did some reading on antibiotics and tendon ruptures. It seems that Cephalexin is associated with increased risk of tendon ruptures, but Doxycycline is actually protective. What I can’t figure out is my relative risk right now. I can’t tell how significant the risk is from the Cephalexin, how protective is they Doxycycline, or whether I should change anything at all in my programming.
I would appreciate your thoughts. I’m happy to schedule a consult if that’s the way to go.
The main concern with respect to tendon issues relates to fluoroquinolone antibiotics; I do not typically get worried about this risk from cephalosporins nearly as much. Neither I nor anyone else can give you an accurate idea of what your actual risk is, but fortunately a 5 day course is very short. Your options could be to carry on as programmed or to modify the intensity of your training while taking this regimen. I don’t know that I can make a strong recommendation either way. If it were me, I would likely carry on as planned given that cephalexin’s risk is still not particularly high, however I can understand the additional concern given your history of a tendon rupture.
I have been off of it for about a week now. If I were to reduce the intensity, is it a matter of going down and then progressing back up, or reduce and maintain for some period of time? Is there a reasonable time window?
I’m skeptical of this study design as a way to answer this particular question.
If you’ve been off of it, I’m not sure there’s much else to do. Any of those potential options you mentioned would be fine too, any due to a lack of evidence, any proposed specific reduction in intensity, or any specific time frame, would be essentially made up – for example, reduce intensity by 10% and work back up over the course of 4 weeks. There would be nothing wrong with that, but it’s not based on anything either. Sorry things aren’t more clear here.