Related Experiment Videos

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
PubMed

Insights

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.
Abstract

Related Concept Videos

Inhibitors of Bacterial DNA Synthesis01:28

Inhibitors of Bacterial DNA Synthesis

Bacterial pathogens depend on precise and efficient DNA replication to sustain infection. Two type II topoisomerases—DNA gyrase and topoisomerase IV—are critical to this process, as they resolve DNA supercoiling and unlink chromosomes during replication. Fluoroquinolones, synthetic derivatives of quinolones, exploit this mechanism by stabilizing the transient DNA–enzyme cleavage complex, preventing strand religation, and causing lethal double-strand breaks. These antibiotics are selectively...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Rocky Mountain Spotted Fever01:26

Rocky Mountain Spotted Fever

Rocky Mountain Spotted Fever (RMSF) is a severe tick-borne illness caused by Rickettsia rickettsii, a Gram-negative, coccobacillary bacterium. This pathogen is an obligate intracellular parasite, requiring a host cell for replication. Transmission occurs through the bite of an infected tick. In the United States, the most important vectors are Dermacentor variabilis (American dog tick) and Dermacentor andersoni (Rocky Mountain wood tick), though other tick species may also serve as vectors.