Safety of oral ciprofloxacin

“…Lesions had Although quinolones are potent, broad spectrum antibacterial compounds, their use in children and animals with immature skeletons is contraindicated because of their toxic effect on articular cartilages. Clinically, quinolones have been implicated as a cause for arthralgia in human patients (1, 2, 19,22,28,29), and experimentally, they have caused lesions in the articular-epiphyseal cartilage complexes (AECC) of various animals (4, 6-8, 12-14, 17, 18, 20, 31, 32).…”

Section: Introduc~ionmentioning

confidence: 99%

Morphologic and Biochemical Changes in Articular Cartilages of Immature Beagle Dogs Dosed with Difloxacin

1992

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Quinolones are efficacious antibacterial compounds, but they have been associated with arthralgia in human patients; experimentally, they have caused lesions in articular cartilages of immature animals. The earliest morphologic and biochemical changes induced in articular-epiphyseal cartilage complexes by difloxacin, a fluoroquinolone, were investigated in 27 3-month-old Beagle dogs that were dosed orally with the drug at 300 m u k g body weight per day. Paraffin-embedded sections of humeral and femoral heads that were stained with either hematoxylin and eosin or toluidine blue and fast green were evaluated histologically, and lesions were scored according to established criteria. Although morphologic changes were not observed in cartilages of the control dogs or of the treated dogs in the 24-hr group, the severity of lesions, as represented by mean scores for lesions, increased during the 36-48 hr after dosing. The initial morphologic change, observed in cartilages from the treated dogs of the 36-and the 48-hr groups, was necrosis ofchondrocytes that was rapidly followed by disruption of extracellular matrix and formation of fissures. Although glycosaminoglycan was aggregated along the margins of fissures, its concentration was not reduced in cartilages of any group of treated dogs. Collagen, however, was depleted from the cartilages of the dogs that were euthanized 36 or 48 hr after the first dose of difloxacin. Because degenerative changes were observed ultrastructurally in chondrocytes by 24 hr in a previous study, it was concluded that collagen was lost from affected cartilages as an early sequel to the degeneration of chondrocytes.

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“…INTRODUCTION Articular cartilage (AC), occupying a thin layer along the ends of long bones, cushions the effects of biomechanical forces operative in synovial joints. This important function in joint articulation coupled with the tissue's strategic location, exact toll over time, and the aged mammalian AC is highly prone to erosive and degenerative lesions (11,13,92). Paradoxically, AC is also a biologically privileged tissue, spared the toxic manifestations of systemically administered xenobiotics because AC lacks innervation or a vascular system (18,29).…”

mentioning

confidence: 99%

“…To this day, however, no unequivocal clinicopathologic data demonstrate that humans are susceptible to this enigmatic drug-induced lesion (2,8,26,47,53,91,92). Experimentally, dogs, rats, rabbits, guinea pigs, and marmosets have been shown to develop QAP ( 11, 46, 49, 10 I).…”

mentioning

confidence: 99%

Review Article: Quinolone Arthropathy—Acute Toxicity to Immature Articular Cartilage

Gough¹,

Kasali²,

Sigler³

et al. 1992

Toxicol Pathol

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A class effect of quinolone antibacterial agents observed during animal toxicity testing is a specific arthropathy (QAP). Despite the growing list of laboratory animals susceptible to QAP and reports of arthralgia in patients treated with quinolones, the potential for QAP development in humans remains unknown. This review discusses current concepts in the biology of articular cartilage and how these concepts elucidate QAP pathogenesis. Biomechanical forces within synovial joints and toxicokinetic properties of quinolones contribute to QAP induction. Since a limited number of mechanistic pathways exist for acute articular damage, QAP may serve as a research tool to probe the pathobiology of injury to articular cartilage.

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Safety of oral ciprofloxacin

Cited by 75 publications

References 5 publications

Single-dose oral ciprofloxacin compared with single-dose intravenous cefazolin for prophylaxis in inguinal hernia repair: a controlled randomized clinical study

Single-dose oral ciprofloxacin compared with single-dose intravenous cefazolin for prophylaxis in inguinal hernia repair: a controlled randomized clinical study

Morphologic and Biochemical Changes in Articular Cartilages of Immature Beagle Dogs Dosed with Difloxacin

Review Article: Quinolone Arthropathy—Acute Toxicity to Immature Articular Cartilage

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