Highlights Multisystem inflammatory syndrome in children affects young Chilean patients. Gastrointestinal symptoms and altered inflammation parameters predominate. Although intensive care was needed, favorable clinical outcomes were achieved. Cases appeared in clusters in the most vulnerable areas of Santiago. Clinical teams must be alert during the weeks after COVID-19 cases rise significantly.

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Warfarin and acenocoumarol are used in various cardiovascular disorders to improve the prognosis of patients with thromboembolic disease. However, there is a lack of substantial efficacy and safety data on antithrombotic prophylaxis in several countries, particularly in Latin America. The aim of this study was to provide information about the efficacy of anticoagulants in Chilean patients. Data were collected from databases of the Western Metropolitan Health Service, Santiago, Chile. We identified 6280 records of patients receiving anticoagulant treatment. The three most common diagnoses were rhythm disorder (43.7%), venous thrombosis (22%), and valvular prosthesis (10.7%). The majority of patients (98.5%) received acenocoumarol while 1.5% of patients received warfarin, at weekly therapeutic doses of 13.6 mg and 30.4 mg, respectively. For total diagnoses, the median time in the therapeutic range was 50%. However, better results, 66.7%, were observed when a telemedicine strategy was used only in Santiago Province. Our findings emphasize that in Chile, where the number of patients receiving anticoagulant treatment increases every year, telemedicine, by committed teams, improves the use of oral anticoagulants and is able to increase quality indicators of anticoagulant treatment care.

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Safety of fluoroquinolones: risks usually forgotten for the clinicianQuinolones are a group of widely used antimicrobials. Although they are considered safe for patients, knowledge of the safety profile is necessary so that professionals become aware of what is necessary to monitor. At the musculoskeletal level, quinolones have the potential to damage cartilage, causing even tendon rupture in infrequent cases. Hypoglycemia / hyperglycemia has been observed at the endocrine level, thus, careful monitoring of glycemia in patients with quinolone is recommended in diabetic patients. At the cardiovascular level, arrhythmias induced by these antimicrobials are rare but severe. At the level of the nervous system, the appearance of alterations of the central nervous system and the peripheral neuropathy are emphasized. When assessing the safety of quinolones, it is important to consider potential interactions with other substances (medical products). In children it is preferred not to use fluoroquinolones because of the potential risk of cartilage damage and growth, effects that do not seem to be so dramatic in the face of new evidence. Despite optimism, the safety of the treatment of these antimicrobials should be evaluated in every pediatric patient.Key words: Fluoroquinolonas, safety, pharmaco surveillance, pediatrics. Palabras clave: Fluoroquinolonas, seguridad, farmacovigilancia, pediatría. IntroducciónL as quinolonas son un grupo de antimicrobianos que ha presentado un aumento progresivo de consumo ambulatorio a través de los años 1 . Gracias a la farmacovigilancia se han detectado reacciones adversas graves que han obligado a retirar del mercado varias fluoroquinolonas 2 . Por ejemplo, grepafloxacina experimentó un retiro voluntario por el efecto de prolongación del intervalo QT, complicación que exponía a los pacientes a riesgo de arritmias ventriculares graves, como la torsión de puntas 3 . Otro ejemplo fue el retiro de gatifloxacina, por alteraciones en los valores de glicemia 4 . El reporte de las reacciones adversas a medicamento a la autoridad regulatoria es un factor clave para la detección oportuna de eventos adversos en nuestra población. Si bien el grupo de las quinolonas es considerado seguro para los pacientes, el conocimiento del perfil de seguridad es necesario para que los profesionales estén en conocimiento de lo que es necesario reportar. Los efectos adversos más frecuentes de las quinolonas son los gastrointestinales (náuseas, vó-mitos, diarrea), las alergias y las reacciones neurológicas (mareo, cefalea, ansiedad) 5 . En los últimos años algunas agencias sanitarias de países desarrollados han emitido alertas de seguridad por reacciones adversas a este grupo de medicamentos y, a pesar de que estos eventos son incluidos en los folletos de información al profesional, son desconocidos para los médicos clínicos.El objetivo de la presente revisión es dar a conocer reacciones adversas de las fluoroquinolonas que han adquirido relevancia clínica en los últimos años, con la intención de que sean detectad...

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