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Tolerance and safety of ciprofloxacin in paediatric patients
A Black1, A O Redmond, H J Steen
1Royal Belfast Hospital for Sick Children, UK.
Insights
Ciprofloxacin demonstrates safety and effectiveness for treating serious pseudomonas infections in children with cystic fibrosis. Long-term monitoring for potential joint issues is recommended.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Medicine
- Pharmacology
Background:
- Pseudomonas aeruginosa infections are a significant concern in cystic fibrosis (CF) patients.
- Effective and safe antibiotic options for pediatric CF patients are crucial.
Purpose of the Study:
- To evaluate the safety and acceptability of ciprofloxacin in children with cystic fibrosis (CF) and serious pseudomonas infections.
- To compare oral ciprofloxacin with combination therapy (ciprofloxacin plus intravenous azlocillin and tobramycin) for respiratory exacerbations in CF patients.
Main Methods:
- Retrospective review of 31 children with CF treated with ciprofloxacin for pseudomonas infections.
- A comparative study involving children aged 10-18 years during four respiratory exacerbations.
- Monitoring of clinical response, adverse events, and drug acceptability.
Main Results:
- Encouraging clinical response and few adverse effects observed in initial treatments.
- Low incidence of adverse reactions, including only one case of arthralgia across all groups.
- A total of 46 potential drug-related adverse events reported in 20202 children treated via named-patient basis.
Conclusions:
- Ciprofloxacin appears to be a safe and effective treatment option for pseudomonas infections in pediatric CF patients.
- While generally well-tolerated, the potential for arthropathy warrants ongoing surveillance.
- Long-term follow-up of children treated with ciprofloxacin is suggested to assess for late-onset adverse effects.
Abstract:
The Cystic Fibrosis Clinic at the Royal Belfast Hospital for Sick Children has treated 31 children with ciprofloxacin, for serious pseudomonas infection in cystic fibrosis, and carefully monitored the safety and acceptability of the drug. Initially, eight very ill children were treated on a named-patient basis, with an encouraging clinical response and few adverse effects. Children aged 10-18 years were included in a study of four consecutive exacerbations of respiratory disease, comparing (i) oral ciprofloxacin in each episode with (ii) ciprofloxacin alternating with intravenous azlocillin and tobramycin. Other children with cystic fibrosis were subsequently treated with ciprofloxacin, as the need arose. In all the groups very few adverse reactions were found; in particular only one child developed arthralgia. A total of 202 children in the UK have been treated with ciprofloxacin on a named-patient basis, and their clinicians have reported 46 adverse events that may have been drug-related. Overall ciprofloxacin appears to be safe and effective in children but concern about the possible occurrence of arthropathy remains and long term follow-up of these children may be necessary.