[Assessing fluoroquinolones as risk factor for musculoskeletal disorders in children: a systematic review and meta-analysis].
BACKGROUND
Joint cartilage toxicity secondary to fluoroquinolone use has been observed in young animals. These early observations led to the contraindication of fluoroquinolones in children under 18 years. Nevertheless, quinolones may be the only option for oral treatment of infections caused by Pseudomonas aeruginosa.


OBJECTIVE
To evaluate by systematic review and meta-analysis the relation between fluoroquinolonas and musculoskeletal disorders in children.


METHODS
Data sources were Medline, Cochrane data base, and free-text search through Google and Yahoo. MESh terms were: quinolones and arthropathy-tendinopathy and children. Randomized clinical trials, cohorts and case-control studies with a primary outcome of arthropaty and/or tendinopathy were included. Each study was scored and classified for methodological key issues according to level of evidence. Data were extracted using a predetermined protocol.


RESULTS
The search identified 277 studies of whom 8 were eligible for inclusion that included 23 166 patients. All except one failed to find a significant link between fluoroquinolones use and musculoskeletal disorders. The pooled odds ratio was 1.02 (CI 0.76-1.38).


CONCLUSIONS
Our meta-analysis does not support musculoskeletal disorders as a result of fluoroquinolones use in children under 18 years. Thus, in selected, appropriate, and mandatory cases fluoroquinolones should not be contraindicated in children.
Área de Evaluación de Tecnologías, Comisión Nacional Salud Investiga, Ministerio de Salud de la Nación. margris2@yahoo.com.ar
María Teresa
MT
Rosanova
Roberto
R
Lede
Haroldo
H
Capurro
Virgilio
V
Petrungaro
Pablo
P
Copertari
D002648:Child; D024841:Fluoroquinolones / Q000009:adverse effects*; D006801:Humans; D009140:Musculoskeletal Diseases / Q000139:chemically induced*; D012307:Risk Factors
D024841:Fluoroquinolones