title: Ciprofloxacin in critically ill children.
abstract: Data regarding the use of fluoroquinolones in critically ill children are scarce. We present our experience regarding the use of ciprofloxacin in this specific patient population. We prospectively identified all paediatric patients who received ciprofloxacin treatment in the intensive care unit of the tertiary care P. & A. Kyriakou Children's Hospital during a three year period (2005 to 2008). Eighteen paediatric patients (mean age 23 months, 12 females) who received intravenous ciprofloxacin were identified. Various underlying diseases, including malignancy and immunodeficiency, were observed. None of the evaluated patients had cystic fibrosis. Fourteen patients had bacteraemia (mainly caused from Gram-negative pathogens), one had Stenotrophomonas maltophilia pneumonia, while no pathogen was identified in three patients. The latter patients received ciprofloxacin due to the severity of their clinical manifestations. All patients with microbiologically documented infections recovered. Three deaths attributed to the underlying diseases were noted. Within a 10-day follow-up, two cases of diarrhoea, one case of vomiting and one case of reversible supraventricular tachycardia were noted. No case of QT prolongation was noted. The short-term follow-up hampered any assessment of joint and cartilage toxicity, potentially associated with ciprofloxacin treatment. Our study suggests that ciprofloxacin may be a useful option for critically ill children without cystic fibrosis. Even though firm conclusions regarding the safety profile of ciprofloxacin in critically ill children could not be drawn, our study provides useful information regarding short-term adverse events associated with ciprofloxacin.
authors.affiliation: Pediatric Intensive Care Unit, Department of Microbiology, University of Athens, "P & A. Kyriakou" Children's Hospital and Alfa Institute of Biomedical Sciences, Athens, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Sideri
authors.forename: D A
authors.initials: DA
authors.lastname: Kafetzis
authors.forename: E K
authors.initials: EK
authors.lastname: Vouloumanou
authors.forename: J H
authors.initials: JH
authors.lastname: Papadatos
authors.forename: M
authors.initials: M
authors.lastname: Papadimitriou
authors.forename: M E
authors.initials: ME
authors.lastname: Falagas
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy; D002675:Child, Preschool; D002939:Ciprofloxacin / Q000009:adverse effects* / Q000627:therapeutic use*; D003422:Critical Care; D016638:Critical Illness; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin