Systemic use of fluoroquinolone in children

Abstract

Fluoroquinolones are an important class of antibiotics that are widely used in adult patients because of their broad spectrum of activity, good tissue penetration, and oral bioavailability. However, fluoroquinolone use in children is limited because juvenile animals developed arthropathy in previous experiments on fluoroquinolone use. Indications for fluoroquinolone use in patients younger than 18 years, as stated by the U.S. Food and Drug Administration, include treatment of complicated urinary tract infections and postexposure treatment for inhalation anthrax. In Korea, the systemic use of fluoroquinolones has not been approved in children younger than 18 years. Although concerns remain regarding the adverse musculoskeletal effects of fluoroquinolones in children, their use in the pediatric population has increased in many circumstances. While pediatricians should be aware of the indications and adverse effects of fluoroquinolones, recent studies have shown that the risk for musculoskeletal complications in children did not significantly increase following fluoroquinolone treatment. In addition, fluoroquinolones may be particularly helpful in treating multidrug-resistant infections that have not responded to standard antibiotic therapy in immunocompromised patients. In the present article, we provide an updated review on the safety and current recommendations for using fluoroquinolones in children.

Antibiotic resistance of Helicobacter pylori in Chinese children: A multicenter retrospective study over 7 years

“…10 The current recommended first-line H. pylori eradication regimen in children contains any two antibiotics of amoxicillin, metronidazole, or clarithromycin along with a proton-pump inhibitor (PPI) for 7 to 14 days. 11 However, their use in children has increased in many circumstances. 11 However, their use in children has increased in many circumstances.…”

“…10 The use of quinolones in pediatric population is relatively contraindicated because fluoroquinolone-treated juvenile animals developed arthropathy in previous experiments, although these observations have not been confirmed in humans yet. 11 However, their use in children has increased in many circumstances. Quinolones-based therapies may be particularly helpful in treating children who have not responded to first-line H. pylori eradication regimen, especially in the case of treatment of multidrug-resistant H. pylori strains.…”

Seguridad de las fluoroquinolonas: riesgos habitualmente olvidados para el clínico

“…Hoy se acepta que no deben ser utilizadas en pacientes pediátricos para infecciones de rutina cuando existe otro antimicrobiano seguro y sólo deberían ser consideradas en infecciones graves, sin otra alternativa de tratamiento 49,50 . Las recomendaciones de uso de fluoroquinolonas en niños por la Academia Americana de Pediatría (AAP) en el año 2016, son las siguientes 51 :…”

How multidrug resistance in typhoid fever affects treatment options

“…[33][34][35] However, because of possible severe side effects, including arthropathy, ciprofloxacin usage in children and young adolescents under 18 years of age is recommended only for life-threatening infections. 36,37 The short treatment course for S. Typhi infection has contributed to the popularity of ciprofloxacin among clinicians. 38 After the introduction of ciprofloxacin, cases of fluoroquinolone-resistant S. Typhi were reported in the early 1990s.…”