title: Safety Concerns Surrounding Quinolone Use in Children.
abstract: Fluoroquinolones are highly effective antibiotics with many desirable pharmacokinetic and pharmacodynamic properties including high bioavailability, large volume of distribution, and a broad spectrum of antimicrobial activity. Despite their attractive profile as anti-infective agents, their use in children is limited, primarily due to safety concerns. In this review we highlight the pharmacological properties of fluoroquinolones and describe their current use in pediatrics. In addition, we provide a comprehensive assessment of the safety data associated with fluoroquinolone use in children. Although permanent or destructive arthropathy remains a significant concern, currently available data demonstrate that arthralgia and arthropathy are relatively uncommon in children and resolve following cessation of fluoroquinolone exposure without resulting in long-term sequelae. The concern for safety and risk of adverse events associated with pediatric fluoroquinolone use is likely driving the limited prescribing of this drug class in pediatrics. However, in adults, fluoroquinolones are the most commonly prescribed broad-spectrum antibiotics, resulting in the development of drug-resistant bacteria that can be challenging to treat effectively. The consequence of misuse and overuse of fluoroquinolones leading to drug resistance is a greater, but frequently overlooked, safety concern that applies to both children and adults and one that should be considered at the point of prescribing.
authors: Department of Pharmacy, Children's Mercy Hospital, University of Missouri-Kansas City, Kansas City, MO, USA.|Divisions of Pediatric Infectious Diseases, Children's Mercy Hospital, University of Missouri-Kansas City, Kansas City, MO, USA.
authors: Karisma
authors: K
authors: Patel
authors: Department of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City, Kansas City, MO, USA.|Divisions of Pediatric Infectious Diseases, Children's Mercy Hospital, University of Missouri-Kansas City, Kansas City, MO, USA.|Clinical Pharmacology, Children's Mercy Hospital, University of Missouri-Kansas City, Kansas City, MO, USA.
authors: Jennifer L
authors: JL
authors: Goldman
mesh_terms: D000367:Age Factors; D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002986:Clinical Trials as Topic / Q000379:methods; D027081:DNA Gyrase / Q000378:metabolism; D024881:Drug Resistance, Bacterial / Q000187:drug effects / Q000502:physiology; D024841:Fluoroquinolones / Q000009:adverse effects* / Q000627:therapeutic use; D005767:Gastrointestinal Diseases / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D009268:Nalidixic Acid / Q000009:adverse effects / Q000627:therapeutic use; D011446:Prospective Studies; D012189:Retrospective Studies; D059005:Topoisomerase II Inhibitors / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D059005:Topoisomerase II Inhibitors; D009268:Nalidixic Acid; D027081:DNA Gyrase
keywords: fluoroquinolones; pediatrics; safety