Ciprofloxacin safety in paediatrics: a systematic review

Adefurin, Abiodun; Sammons, Helen; Jacqz-Aigrain, Évelyne; Choonara, Imti

doi:10.1136/adc.2010.208843

Cited by 145 publications

(102 citation statements)

References 100 publications

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“…This report could be at variance with the report of Adefurin et al (2011). Who stated that a total of 16184 pediatric patients who were exposed to Ciprofloxacin and 1065 reported cases of musculoskeletal adverse effects were observed.…”

Section: Human Studiescontrasting

confidence: 55%

Ciprofloxacin Induced Chondrotoxicity and Tendinopathy

Adikwu

Nelson

2012

American Journal of Pharmacology and Toxicology

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ABSRACTCiprofloxacin is one of the fluoroquinolones with a wide clinical acceptability. Rescently there are increasing reports on Ciprofloxacin induce Chondrotoxicity and Tendinopathy in Animal experiment and clinical experience which is of great clinical concern. A comprehensive survey and review of literaure on reported ciprofloxacin induced Chondrotoxicity and Tendinopathy in Humans and Animals was performed. It was observd that ciprofloxacin is a potential inducer of Chrondrotoxicity and Tendinopathy which could be potentiated by coadministration with corticosteroids.This conditions were reported to be characterised by cartilage lesion, matrix swelling, inhibition of chondrocytes proliferation, secretion of soluble proteoglycan, modification of the metabolism and integrity of extracellular proteins, decrease in epiphyseal growth plate, humerus and femur.The mechanism behind this phenomenon is said to be multifactoral. Ciprofloxacin induced Chrondrotoxicity and Tendinopathy in growing animals is attributed to oxidative stress (lipid peroxidation, Deoxyribonucleic Acid (DNA) oxidative stress). Ciprofloxacin induced cartilage damage may also be attributed to formation of Ciprofloxacin chelates and complexes which possesses the potential to induce a deficiency of functionally available divalent ions resulting in cytoskeletal changes. Animal studies showed that oxidative damage or metabolism of tissues was also found suggesting the involvement of a reactive oxygen species. Administration of magnesium, zinc chloride and vitamin E (α tocopherol) were found to prevent or reverse ciprofloxacin induced Chrondrotoxicity and Tendinopathy. Through excess formation of collagen, increase osteoblastic activity, increase bone growth, inhibition of free oxidation radicals' formation thereby preventing DNA oxidation and oxidative stress. Zinc also directly stimulates DNA synthesis either by enzyme stimulation or altering, the binding of f1 and f3 histones to DNA so as to affect RNA synthesis. Patient medical history should be considered before Ciprofloxacin recommendation. Coadministration with corticosteroid should be done with caution. Further evaluation of antioxidants effect in Ciprofloxacin induce Chonrotoxicity, Tendinopathy in humans could be of clinical importance as observed in Animal studies.

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Section: Human Studiescontrasting

confidence: 55%

Ciprofloxacin Induced Chondrotoxicity and Tendinopathy

Adikwu

Nelson

2012

American Journal of Pharmacology and Toxicology

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“…A caution with children is the potential for damage to growing weight-bearing joints and cartilage, based on studies in immature animals. The available evidence in humans suggests that if used in short courses the risk of an effect on growth and joint development is low and that musculo-skeletal side effects are reversible (544)(545)(546)(547)(548)(549)(550)(551). In most countries the use of fluoroquinolones in children is relatively contraindicated except for use in multidrug resistant infections where there are no suitable alternative.…”

Section: Fluoroquinolonesmentioning

confidence: 99%

Epidemiology, Clinical Presentation, Laboratory Diagnosis, Antimicrobial Resistance, and Antimicrobial Management of Invasive Salmonella Infections

et al. 2015

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SUMMARY Salmonella enterica infections are common causes of bloodstream infection in low-resource areas, where they may be difficult to distinguish from other febrile illnesses and may be associated with a high case fatality ratio. Microbiologic culture of blood or bone marrow remains the mainstay of laboratory diagnosis. Antimicrobial resistance has emerged in Salmonella enterica , initially to the traditional first-line drugs chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole. Decreased fluoroquinolone susceptibility and then fluoroquinolone resistance have developed in association with chromosomal mutations in the quinolone resistance-determining region of genes encoding DNA gyrase and topoisomerase IV and also by plasmid-mediated resistance mechanisms. Resistance to extended-spectrum cephalosporins has occurred more often in nontyphoidal than in typhoidal Salmonella strains. Azithromycin is effective for the management of uncomplicated typhoid fever and may serve as an alternative oral drug in areas where fluoroquinolone resistance is common. In 2013, CLSI lowered the ciprofloxacin susceptibility breakpoints to account for accumulating clinical, microbiologic, and pharmacokinetic-pharmacodynamic data suggesting that revision was needed for contemporary invasive Salmonella infections. Newly established CLSI guidelines for azithromycin and Salmonella enterica serovar Typhi were published in CLSI document M100 in 2015.

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“…As noted earlier (211)(212)(213)(214). The use of ciprofloxacin monotherapy can be complicated by the development of antibiotic resistance.…”

Section: Guideline 19 -Treatment Of Catheter-related Infectionmentioning

confidence: 99%