[On fluoroquinolones treatment safety in children (clinical, morphological and catamnesis data)]

Area of Science:

• Pediatric Pharmacology
• Rheumatology
• Infectious Diseases

Background:

• Monofluoroquinolones are broad-spectrum antibiotics used in pediatric populations.
• Arthropathy is a known potential adverse effect of fluoroquinolone use.
• Understanding the specific characteristics of fluoroquinolone-induced arthropathy in children is crucial for safe prescribing.

Purpose of the Study:

• To investigate and compare the development and characteristics of monofluoroquinolone-induced arthropathy in children with mucoviscidosis and aplastic anemia.
• To identify factors influencing the development of arthropathy, such as drug type, patient age, and underlying condition.
• To evaluate the prognosis and specific features of arthropathy in pediatric patients.

Main Methods:

• Prospective comparative investigation involving 144 children with mucoviscidosis and 37 with aplastic anemia.
• Analysis based on clinical follow-up (catamnesis), annual growth rate assessment, and postmortem morphological examination of knee joints.
• Comparison of arthropathy development based on different antibacterial treatment regimens and durations.

Main Results:

• Fluoroquinolone arthropathy developed within the first three weeks of treatment, irrespective of duration.
• Arthropathy development was dependent on the specific fluoroquinolone drug, patient age, and underlying disease (nosology).
• Arthropathy demonstrated a favorable prognosis, with complete resolution occurring between 7 days and 3 months, and notably, no cartilage damage was observed morphologically.

Conclusions:

• Fluoroquinolone-induced arthropathy in children has specific features, including the absence of cartilage damage.
• The onset of arthropathy is rapid, occurring early in the treatment course.
• Treatment duration does not influence arthropathy development, but drug, age, and condition do; the prognosis is generally favorable.