Growth and development in preterm infants receiving fluoroquinolones

Abstract

Growth and development were followed in 7 preterm newborn infants who received fluoroquinolones in the neonatal period. Quinolones were used as a "life saving" therapy in cases of sepsis caused by bacterial agents sensitive only to these drugs. Two other groups of neonates matched for gender, birth weight and gestational age served as controls. Although the quinolone group had more severe illness, no statistically significant differences were observed in growth and development between the groups. No osteoarticular problems or joint deformities were observed in the quinolone group. Therefore, quinolones could be a therapeutic option for newborns with sepsis caused by multiply resistant organisms.

Ciprofloxacin safety in paediatrics: a systematic review

“…Radiological confirmation of arthropathy using MR1 was positive in two studies involving six cystic fibrosis patients, who had joint effusions, abnormal thickness of articular cartilage, non-homogeneous structure of cartilage or altered two-layer appearance of cartilage 79 91. In addition to clinical examination and radiological investigation, seven studies (531 cases and 674 controls) investigated the effects of ciprofloxacin on growth of patients after following up the patients for 6–50 months 28 32 33 63 75 109 116. None of these studies found any significant difference in growth of the ciprofloxacin exposed patients compared with the control arm.…”

“…Analysis of 23 controlled studies (7 controlled studies were excluded because ciprofloxacin or another fluoroquinolone was administered in the comparator arm) comprising 6481 cases and 17 441 controls showed that there is a 57% increased risk of arthropathy in patients who received ciprofloxacin compared to the comparator arm (OR 1.57, 95% CI 1.26 to 1.97) 13 15–19 28–33 63 75 76 79 101 103 105 109 111 112 116. Further analysis of five controlled studies that included only cystic fibrosis patients (227 cases and 391 controls) estimated a 67% increased risk of arthropathy (OR 1.67, 95% CI 1.13 to 2.45) 17 19 79 101 105…”

Fluoroquinolone Safety in Pediatric Patients: A Prospective, Multicenter, Comparative Cohort Study in France

“…Little is known about FQ safety in newborns and infants. 46,47 However, laboratory findings in juvenile animals indicated that younger animals were at higher risk of cartilage damage. [5][6][7] Therefore, future studies perhaps should focus on this age group with long-term follow-up.…”

The New Fluoroquinolones: A Critical Review

“…However, because the potential to cause harm exists, further study is needed before the fluoroquinolones can be recommended for routine use in paediatric patients. A study by Martell et al (232) assessed whether growth of preterm infants was affected by administration of a fluoroquinolone. This study reported lower weight and smaller head circumference in the fluoroquinolone-treated individuals, relative to a reference group.…”

“…This study reported lower weight and smaller head circumference in the fluoroquinolone-treated individuals, relative to a reference group. It was not clear whether this was due to treatment with a fluoroquinolone or another variable such as the severity of illness (232).…”