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Fluoroquinolones in paediatrics.
Paediatr Drugs. 2001; 3(5):365-77.PD

Abstract

The fluoroquinolones are an important group of antibiotics, which are widely used in adult patients because of their high penetration in tissues and bactericidal activity. However, they are not licensed for paediatric use (except the limited indication of Pseudomonas infection in cystic fibrosis) because of their potential to cause joint toxicity (observed in experiments using juvenile animal models). In recent years, there has been a change in the susceptibility of pathogens to widely used antibiotics; however, many of these pathogens remain sensitive to the fluoroquinolones (agents which can often be administered orally to treat severe infections). Fluoroquinolones have a number of potential indications in children: cystic fibrosis, intestinal infections due to resistant strains of Salmonella spp. and Shigella spp., severe infections due to Enterobacteriaceae (including the neonatal period), complicated urinary tract infections, the immunocompromised host, and some mycobacterial infections. The third generation fluoroquinolones have improved activity against Gram-positive bacteria and could be useful in respiratory tract, and ear, nose and throat infections in adult patients. Their potential role in routine use for paediatric patients will remain limited because of potential joint complications and the availability of other treatment options. However, available clinical data does indicate that the incidence of arthrotoxicity in children treated with ciprofloxacin appears to be the same as that in adult patients. The use of other fluoroquinolones is too rare to obtain meaningful information on their toxicity in children. For future fluoroquinolones, pneumococcal meningitis will probably be a potential indication. Despite their important activity, fluoroquinolones remain a second-line treatment in children, for use following the failure of a well established antibiotic treatment, to avoid potential adverse effects and the emergence of resistant strains.

Authors+Show Affiliations

Department of Paediatrics, Hĵpital Saint Vincent de Paul, Paris, France. dominique.gendrel@svp.ap-hop-paris.frNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

11393329

Citation

Gendrel, D, and F Moulin. "Fluoroquinolones in Paediatrics." Paediatric Drugs, vol. 3, no. 5, 2001, pp. 365-77.
Gendrel D, Moulin F. Fluoroquinolones in paediatrics. Paediatr Drugs. 2001;3(5):365-77.
Gendrel, D., & Moulin, F. (2001). Fluoroquinolones in paediatrics. Paediatric Drugs, 3(5), 365-77.
Gendrel D, Moulin F. Fluoroquinolones in Paediatrics. Paediatr Drugs. 2001;3(5):365-77. PubMed PMID: 11393329.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fluoroquinolones in paediatrics. AU - Gendrel,D, AU - Moulin,F, PY - 2001/6/8/pubmed PY - 2001/10/5/medline PY - 2001/6/8/entrez SP - 365 EP - 77 JF - Paediatric drugs JO - Paediatr Drugs VL - 3 IS - 5 N2 - The fluoroquinolones are an important group of antibiotics, which are widely used in adult patients because of their high penetration in tissues and bactericidal activity. However, they are not licensed for paediatric use (except the limited indication of Pseudomonas infection in cystic fibrosis) because of their potential to cause joint toxicity (observed in experiments using juvenile animal models). In recent years, there has been a change in the susceptibility of pathogens to widely used antibiotics; however, many of these pathogens remain sensitive to the fluoroquinolones (agents which can often be administered orally to treat severe infections). Fluoroquinolones have a number of potential indications in children: cystic fibrosis, intestinal infections due to resistant strains of Salmonella spp. and Shigella spp., severe infections due to Enterobacteriaceae (including the neonatal period), complicated urinary tract infections, the immunocompromised host, and some mycobacterial infections. The third generation fluoroquinolones have improved activity against Gram-positive bacteria and could be useful in respiratory tract, and ear, nose and throat infections in adult patients. Their potential role in routine use for paediatric patients will remain limited because of potential joint complications and the availability of other treatment options. However, available clinical data does indicate that the incidence of arthrotoxicity in children treated with ciprofloxacin appears to be the same as that in adult patients. The use of other fluoroquinolones is too rare to obtain meaningful information on their toxicity in children. For future fluoroquinolones, pneumococcal meningitis will probably be a potential indication. Despite their important activity, fluoroquinolones remain a second-line treatment in children, for use following the failure of a well established antibiotic treatment, to avoid potential adverse effects and the emergence of resistant strains. SN - 1174-5878 UR - https://www.unboundmedicine.com/medline/citation/11393329/Fluoroquinolones_in_paediatrics_ L2 - https://dx.doi.org/10.2165/00128072-200103050-00005 DB - PRIME DP - Unbound Medicine ER -