title: Ciprofloxacin treatment in preterm neonates in Bangladesh: lack of effects on growth and development.
abstract: BACKGROUND
  Quinolone-induced arthropathic toxicity in weight-bearing joints observed in juvenile animals during preclinical testing has largely restricted the routine use of ciprofloxacin in the pediatric age group. As histopathologic, radiologic and magnetic resonance imaging monitoring evidence has gathered supporting the safety of fluoroquinolones in children, many pediatricians have started to prescribe quinolones to some patients on a compassionate basis.
  
  
  OBJECTIVE
  The objective of this study was to ascertain the safety of ciprofloxacin in preterm neonates <33 weeks gestational age treated at Dhaka Shishu (Children) Hospital in Bangladesh.
  
  
  METHODS
  Long-term follow up was done to monitor the growth and development of preterm infants who were administered intravenous ciprofloxacin in the neonatal period. Ciprofloxacin was used only as a life-saving therapy in cases of sepsis produced by bacterial agents resistant to other antibiotics. Another group of preterm neonates with septicemia who were not exposed to ciprofloxacin, but effectively treated with other antibiotics and followed up, were matched with cases for gender, gestational age and birth weight and included as a comparison group. Forty-eight patients in the ciprofloxacin group and 66 patients in the comparison group were followed up for a mean of 24.7 +/- 18.5 months and 21.6 +/- 18.8 months, respectively.
  
  
  RESULTS
  No osteoarticular problems or joint deformities were observed in the ciprofloxacin group during treatment or follow up. No differences in growth and development between the groups were found.
  
  
  CONCLUSIONS
  Ciprofloxacin is a safe therapeutic option for newborns with sepsis produced by multiply resistant organisms.
authors.affiliation: Department of Neonatology, Child Development Centre, Child Development and Neurology Unit, Dhaka, Bangladesh.
authors.forename: A S M Nawshad Uddin
authors.initials: AS
authors.lastname: Ahmed
authors.forename: Naila Z
authors.initials: NZ
authors.lastname: Khan
authors.forename: Samir K
authors.initials: SK
authors.lastname: Saha
authors.forename: M A K Azad
authors.initials: MA
authors.lastname: Chowdhury
authors.forename: Humaira
authors.initials: H
authors.lastname: Muslima
authors.forename: Paul
authors.initials: P
authors.lastname: Law
authors.forename: Maksuda
authors.initials: M
authors.lastname: Islam
authors.forename: Mallika
authors.initials: M
authors.lastname: Bhattacharya
authors.forename: Gary L
authors.initials: GL
authors.lastname: Darmstadt
mesh_terms: D001459:Bangladesh; D002657:Child Development / Q000187:drug effects*; D002939:Ciprofloxacin / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D007235:Infant, Premature, Diseases / Q000188:drug therapy*; D007275:Injections, Intravenous; D008297:Male; D018805:Sepsis / Q000188:drug therapy*
chemical_list: D002939:Ciprofloxacin