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Growth and joint symptoms in children treated with nalidixic acid
M Nuutinen1, J Turtinen, M Uhari
1Department of Pediatrics, University of Oulu, Finland.
Insights
Nalidixic acid, a type of quinolone, did not affect growth or cause joint problems in children treated for urinary tract infections. Long-term studies show these medications are safe for pediatric use.
Area of Science:
- Pediatric Pharmacology
- Rheumatology
- Infectious Diseases
Background:
- Recurrent urinary tract infections (UTIs) in children often require long-term medication.
- Quinolones, including nalidixic acid, are used for UTIs, but their long-term effects on pediatric growth and joints are a concern.
Purpose of the Study:
- To investigate the long-term effects of nalidixic acid on the growth and joint health of children.
- To determine if nalidixic acid treatment for recurrent UTIs is associated with arthropathies or growth disturbances.
Main Methods:
- A case-control study identified 78 children treated with nalidixic acid and matched them with 156 controls.
- Joint symptoms and growth data were assessed, with detailed growth analysis in 39 case-control pairs over a mean follow-up of 19.6 years.
Main Results:
- No significant differences in joint symptoms or treatments for arthropathies were observed between nalidixic acid-treated children and controls.
- Analysis of growth data revealed no growth disturbances, and final adult heights were similar between cases and controls.
Conclusions:
- Nalidixic acid treatment in children for recurrent UTIs does not appear to cause arthropathies or hinder growth.
- These findings support the safety of short-term quinolone use in pediatric populations.
Abstract:
To analyze the effects of quinolones on growth and joints in children we identified 78 patients who had been receiving nalidixic acid for 116 days on the average (range, 3 to 570 days) from a random sample of 3094 of 16,409 children treated with long term medication because of recurrent urinary tract infection. Two controls per each index case, matched for sex and the age at which the first medication for recurrent urinary tract infection occurred, were chosen. Frequency of joint symptoms and examinations or possible treatments for arthropathies were similar in the index (n = 44) and control (n = 62) cases. Detailed growth data were analyzed from 39 case-control pairs after the mean follow-up time of 19.6 years (range, 14.8 to 24.7 years), and no growth disturbances were found. The final heights (age, > 18 years) of the index and control cases were similar (n = 31 case-control pairs). We conclude that nalidixic acid does not cause arthropathies or hamper growth in children, which supports the suggestion that at least short treatment periods with quinolones are safe.