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Do fluoroquinolones commonly cause arthropathy in children?
Clinton T Forsythe1, Michael E Ernst
1University of Minnesota Medical Centre, Fairview, Minnesota, Unites States.
CJEM
|December 13, 2007
Summary
Published data does not adequately support a link between fluoroquinolone (FQ) use and arthropathy in children. Concerns about FQ-related joint issues should not prevent their necessary use in pediatric patients.
Area of Science:
- Pediatric pharmacology
- Drug safety
- Musculoskeletal health
Background:
- Fluoroquinolones (FQs) are broad-spectrum antibiotics.
- Concerns exist regarding potential arthropathy associated with FQ use in children.
- Evidence linking FQ use to pediatric arthropathy requires thorough evaluation.
Purpose of the Study:
- To review the relationship between fluoroquinolone (FQ) administration and the incidence of arthropathy in pediatric populations.
- To synthesize findings from clinical trials and meta-analyses concerning FQ-induced arthropathy in children.
Main Methods:
- A systematic literature search of PubMed was conducted from January 1980 to February 2007.
- Included studies were clinical trials or meta-analyses focusing on FQ use in pediatric humans with arthropathy or tendinopathy as primary outcomes.
- Studies primarily focused on FQ efficacy or those where safety was a secondary endpoint were excluded.
Main Results:
- Review of 4 retrospective studies was performed.
- Three studies found no significant association between fluoroquinolone treatment and musculoskeletal injury.
- One study noted a correlation between pefloxacin use and arthropathy, yet supported judicious FQ use in pediatric cases.
Conclusions:
- Current published safety trial data in pediatric populations do not sufficiently support a link between fluoroquinolone use and arthropathy.
- Physicians should not be deterred from using fluoroquinolones in pediatric patients when clinically indicated due to arthropathy concerns.
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