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Ciprofloxacin in multi-resistant infections in childhood: an audit
1Department of Paediatrics, Aga Khan University, Karachi.
Insights
Ciprofloxacin showed good or fair therapeutic response in pediatric patients, but its use is concerning due to potential joint toxicity and emerging resistance. Careful regulation of ciprofloxacin in children is recommended.
Area of Science:
- Pediatric Infectious Diseases
- Pharmacology
- Clinical Pharmacy
Background:
- Fluoroquinolones, including ciprofloxacin, offer efficacy against multiresistant bacteria.
- The use of ciprofloxacin in pediatric patients is debated due to concerns about potential articular toxicity.
Purpose of the Study:
- To retrospectively review ciprofloxacin usage in pediatric inpatients.
- To assess the efficacy, safety, and resistance patterns of ciprofloxacin in children.
Main Methods:
- Retrospective review of 21 pediatric inpatient cases treated with ciprofloxacin between June 1991 and September 1993.
- Analysis of treatment response, concurrent antibiotic use, and development of ciprofloxacin resistance.
Main Results:
- Ciprofloxacin was administered alone in 11 cases (52%) and in combination in 10 (48%).
- Therapeutic response was rated 'good' or 'fair' in 13 cases (62%).
- Ciprofloxacin resistance was detected in 4 cases (19%), and it was the sole sensitive antibiotic in 4 cases (19%). No toxic effects were observed, but follow-up was limited.
Conclusions:
- Ciprofloxacin demonstrated clinical efficacy in pediatric patients but raises concerns regarding articular toxicity and the emergence of resistant strains.
- Limited follow-up and increasing resistance highlight the necessity for regulated ciprofloxacin use in pediatric populations.
Abstract:
Ciprofloxacin is a new orally administrable fluoroquinolones, with considerable efficacy against multiresistant organisms. Its use in the paediatric age group however, is controversial because of the risk of potential articular toxicity. We retrospectively reviewed ciprofloxacin usage over a 32 week periods (June, 1991-September, 1993) in paediatric inpatients at The Aga Khan University Hospital. Ciprofloxacin was used in 21 cases, singly in 11 (52%) and in combination with other antibiotics in a further 10 (48%). The response to therapy was adjudged as 'good' or 'fair' in 13 (62%) cases. Ciprofloxacin was the only sensitive antibiotic in 4 (19%) and resistance to it was detected in another 4 (19%) cases. Despite all efforts, adequate follow-up could only be achieved in a third of the patients. Although no toxic or side effects were detected, in view of poor follow-up and emergence of ciprofloxacin resistant strains, our experience highlights the need to regulate ciprofloxacin use in the paediatric age group.