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Ciprofloxacin use: acute arthropathy and long-term follow up
1Department of Pediatrics, Seth G.S. Medical College, Parel, Mumbai.
Insights
Ciprofloxacin can cause temporary joint pain in children, but this study found no evidence of permanent joint damage from its use. Long-term follow-up confirmed no lasting effects in most children treated with this antibiotic.
Area of Science:
- Pediatric pharmacology
- Drug safety and pharmacovigilance
- Musculoskeletal health
Background:
- Ciprofloxacin is a fluoroquinolone antibiotic used in pediatric populations.
- Concerns exist regarding potential long-term joint-related adverse effects in children treated with ciprofloxacin.
- Understanding the safety profile of ciprofloxacin in children is crucial for clinical practice.
Purpose of the Study:
- To evaluate the long-term safety of ciprofloxacin in children regarding permanent joint damage.
- To assess the incidence of delayed arthropathy following ciprofloxacin treatment in pediatric patients.
Main Methods:
- A retrospective questionnaire-based follow-up study was conducted.
- Data were collected from 3341 children treated with ciprofloxacin in 1990, including those with acute arthropathy.
- Pediatricians provided long-term follow-up information on joint-related complaints.
Main Results:
- Long-term follow-up (minimum 2 years) was available for 582 children.
- No joint-related complaints were reported in 581 children during the follow-up period.
- One child with prior acute arthropathy was asymptomatic at follow-up; acute arthropathy in other reported cases was reversible.
Conclusions:
- Ciprofloxacin can induce acute, reversible arthropathy in children.
- This study found no evidence of delayed arthropathy or permanent joint damage associated with ciprofloxacin use.
- The long-term safety profile regarding joint health appears favorable.
Objective:
To assess whether children treated with ciprofloxacin in 1990 had developed any permanent joint damage.
Design:
Retrospective questionnaire-based follow-up study.
Setting:
Adverse Drug Reaction (ADR) Monitoring Center in Mumbai.
Subjects:
3341 children treated with ciprofloxacin in 1990, including 7 who had developed a ciprofloxacin-related acute arthropathy.
Methods:
A questionnaire was sent in January 1995 to 147 pediatricians who had reported to us children in whom ciprofloxacin was prescribed in 1990. The information sought for included the number of children who had followed-up beyond 2 years and details of any joint-related complaints noted in them on long-term follow-up.
Results:
Long-term follow-up was reported in 582 of these 3341 children. No joint-related complaints had developed in 581 children, either as an acute ADR in 1990 or as a delayed ADR during a minimum follow-up period of 2 years. Long-term follow-up was available in only 1 of the 7 children in whom a ciprofloxacin-related acute arthropathy had developed in 1990, and this child was now asymptomatic. New information was received about 13 children treated with ciprofloxacin during 1991-1994 who had developed a ciprofloxacin-related acute arthropathy. In the total 20 children, aged 2-12 years, reported to us for acute ADR, the arthropathy (joint pains, restriction of joint movements and/or swelling of joint) had developed on day 1 to 8 of ciprofloxacin therapy, and in 18 the acute arthropathy had resolved within 1 day to 4 weeks of either discontinuing or completing ciprofloxacin therapy. Outcome in the remaining 2 children was not available.
Conclusions:
Ciprofloxacin use can cause an acute reversible arthropathy, but in this study there is no evidence that its use can cause a delayed arthropathy or any permanent joint damage.