Tendon or joint disorders in children after treatment with fluoroquinolones or azithromycin

Yee, Chuen L.; Duffy, Ciarán M.; Gerbino, Peter G.; Stryker, Scott; Noel, Gary J.

doi:10.1097/00006454-200206000-00009

Cited by 84 publications

(45 citation statements)

References 9 publications

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“…A rather large body of information regarding fluoroquinolone use in children and adolescents for a variety of conditions has accumulated, mainly due to compassionate use in certain pediatric patient populations (1,3,14,27,29). There has been no report in the scientific literature of a definitive fluoroquinolone-associated case of arthropathy in a child despite several radiological and magnetic resonance imaging investigations (3,8,14,22).…”

Section: Discussionmentioning

confidence: 99%

“…There has been no report in the scientific literature of a definitive fluoroquinolone-associated case of arthropathy in a child despite several radiological and magnetic resonance imaging investigations (3,8,14,22). Retrospective reviews and prospective studies support the view that fluoroquinolone-associated toxicity unique to children may not occur or occurs at frequencies that are extremely low (1,3,14,23,27,29).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Susceptibilities to Levofloxacin in Streptococcus pneumoniae , Haemophilus influenzae , and Moraxella catarrhalis Clinical Isolates from Children: Results from 2000-2001 and 2001-2002 TRUST Studies in the United States

Karlowsky¹,

Thornsberry

Critchley³

et al. 2003

Antimicrob Agents Chemother

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Among respiratory tract isolates of Streptococcus pneumoniae from children, resistance to penicillins, cephalosporins, macrolides, and trimethoprim-sulfamethoxazole (SXT) increases on an annual basis. Pediatric patients who do not respond to conventional therapy for respiratory tract infections someday may be treated with fluoroquinolones. In this study, MICs of ␤-lactams, azithromycin, SXT, and levofloxacin were determined and interpreted by using NCCLS guidelines for isolates of S. pneumoniae

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Susceptibilities to Levofloxacin in Streptococcus pneumoniae , Haemophilus influenzae , and Moraxella catarrhalis Clinical Isolates from Children: Results from 2000-2001 and 2001-2002 TRUST Studies in the United States

Karlowsky¹,

Thornsberry

Critchley³

et al. 2003

Antimicrob Agents Chemother

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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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“…22,23 Study of a large database did not demonstrate a difference in musculoskeletal toxicity between patients receiving ciprofloxacin or ofloxacin and azithromycin. 24 Fluoroquinolone-associated tendinopathy in adults is more likely to occur in older patients, patients receiving systemic corticosteroids, and patients with renal disease. 25 …”

Section: Arthropathy In Pediatric Patientsmentioning

confidence: 99%

The Use of Systemic Fluoroquinolones

Powell¹,

Baltimore²,

Bernstein³

et al. 2006

Pediatrics

130

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The only indications for which a fluoroquinolone (ie, ciprofloxacin) is licensed by the US Food and Drug Administration for use in patients younger than 18 years are complicated urinary tract infections, pyelonephritis, and postexposure treatment for inhalation anthrax. Nonetheless, approximately 520 000 prescriptions for fluoroquinolones were written in the United States for patients younger than 18 years in 2002; 13 800 were written for infants and children 2 to 6 years of age, and 2750 were written for infants younger than 2 years. Clinical trials of fluoroquinolones in pediatric patients with various diagnoses have been published and are reviewed. Fluoroquinolones cause arthrotoxicity in juvenile animals and have been associated with reversible musculoskeletal events in both children and adults. Other adverse events associated with fluoroquinolones include central nervous system disorders, photosensitivity, disorders of glucose homeostasis, prolongation of QT interval with rare cases of torsade de pointes (often lethal ventricular arrhythmia in patients with long QT syndrome), hepatic dysfunction, and rashes. The increased use of fluoroquinolones in adults has resulted in increased bacterial resistance to this class of antibacterial agents. This report provides specific guidelines for the systemic use of fluoroquinolones in children. Fluoroquinolone use should be restricted to situations in which there is no safe and effective alternative to treat an infection caused by multidrug-resistant bacteria or to provide oral therapy when parenteral therapy is not feasible and no other effective oral agent is available.

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Tendon or joint disorders in children after treatment with fluoroquinolones or azithromycin

Abstract: In this observational study involving more than 6000 FQ-treated children, the incidence of TJD associated with selected FQ use in children was <1% and was comparable with that of the reference group, children treated with AZ.

Cited by 84 publications

References 9 publications

Susceptibilities to Levofloxacin in Streptococcus pneumoniae , Haemophilus influenzae , and Moraxella catarrhalis Clinical Isolates from Children: Results from 2000-2001 and 2001-2002 TRUST Studies in the United States

Susceptibilities to Levofloxacin in Streptococcus pneumoniae , Haemophilus influenzae , and Moraxella catarrhalis Clinical Isolates from Children: Results from 2000-2001 and 2001-2002 TRUST Studies in the United States

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

The Use of Systemic Fluoroquinolones

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