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Severe ciprofloxacin-associated pseudomembranous colitis in an eight-year-old child

Carlos A Angel1, Justtin Green, Leonard Swischuk

  • 1Department of Surgery (Pediatric Surgery), The University of Texas Medical Branch, Galveston, TX 77555-0353, USA.

Journal of Pediatric Surgery
|October 16, 2004
PubMed

Insights

Severe Clostridium difficile infection occurred in an 8-year-old child treated with oral ciprofloxacin. Fluoroquinolone use in children is not established and off-label use is discouraged.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Clostridium difficile is a primary cause of antibiotic-associated diarrhea and pseudomembranous enterocolitis in pediatric patients.
  • The safety and efficacy of fluoroquinolones in children remain unestablished.
  • Fluoroquinolones are a class of antibiotics often used for their broad-spectrum activity.

Observation:

  • A severe case of pseudomembranous colitis developed in an 8-year-old child.
  • The child had received oral ciprofloxacin as part of an investigational protocol.
  • Ciprofloxacin is a fluoroquinolone antibiotic.

Findings:

  • The case demonstrates a potential risk of severe Clostridium difficile infection associated with fluoroquinolone use in children.
  • Antibiotic-associated colitis can manifest severely even in pediatric populations.
  • The development of pseudomembranous enterocolitis highlights the disruption of normal gut flora.

Implications:

  • Clinicians should exercise caution when considering fluoroquinolone therapy for pediatric patients.
  • Off-label use of fluoroquinolones in children, particularly as oral antipseudomonas agents, is strongly discouraged outside of approved investigational protocols.
  • Further research is needed to establish the safety profile of fluoroquinolones in pediatric populations.

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