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Potential role of fluoroquinolones in pediatric infections

S M Douidar1, W R Snodgrass

  • 1Department of Pediatrics, University of Texas Medical Branch, Galveston 77550.

Reviews of Infectious Diseases
|November 1, 1989
PubMed

Insights

Fluoroquinolones are effective broad-spectrum antibiotics for pediatric infections, including those caused by resistant bacteria. While animal studies raised concerns, clinical trials in children show no joint toxicity, suggesting cautious use in specific cases.

Area of Science:

  • Pharmacology
  • Pediatric Infectious Diseases
  • Antimicrobial Agents

Background:

  • Fluoroquinolones represent a class of broad-spectrum, bactericidal antimicrobial agents.
  • Structurally, they are related to nalidixic acid and exhibit excellent oral absorption.
  • They achieve serum and tissue concentrations exceeding minimal inhibitory levels for susceptible pathogens.

Purpose of the Study:

  • To evaluate the potential use of fluoroquinolones in treating serious pediatric infections.
  • To assess the safety and efficacy of fluoroquinolones in pediatric populations.
  • To address concerns regarding potential cartilage and joint toxicity.

Main Methods:

  • Review of existing literature on fluoroquinolone activity and clinical trials.
  • Analysis of spectrum of activity against pediatric pathogens.
  • Examination of safety data from European and US clinical trials in children.

Main Results:

  • Fluoroquinolones demonstrate activity against key pediatric pathogens like Haemophilus influenzae, Pseudomonas aeruginosa, and methicillin-resistant Staphylococcus aureus.
  • Potential applications include cystic fibrosis pulmonary infections, resistant bacterial meningitis, and prophylaxis in immunocompromised children.
  • Clinical trials in children have not revealed cartilage or joint toxicity.

Conclusions:

  • Fluoroquinolones show promise for treating specific, difficult-to-treat pediatric infections.
  • Current clinical data suggest a favorable safety profile regarding joint toxicity in children.
  • Further clinical experience is recommended, with use currently advised for therapeutic failure or multiple antibiotic resistance.

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