Ciprofloxacin treatment in preterm neonates in Bangladesh: lack of effects on growth and development.
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.
Ahmed
A S M Nawshad Uddin
AS
Department of Neonatology, Child Development Centre, Child Development and Neurology Unit, Dhaka, Bangladesh.
Khan
Naila Z
NZ
Saha
Samir K
SK
Chowdhury
M A K Azad
MA
Muslima
Humaira
H
Law
Paul
P
Islam
Maksuda
M
Bhattacharya
Mallika
M
Darmstadt
Gary L
GL
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*
D002939:Ciprofloxacin