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Quinolone-induced arthropathy: an update focusing on new mechanistic and clinical data.
Int J Antimicrob Agents. 2009 Mar; 33(3):194-200.IJ

Abstract

Quinolones possess favourable antibacterial and pharmacokinetic characteristics and are often used as anti-infective agents in adults. They are contraindicated in children and adolescents because they damage weight-bearing joints in juvenile animals. In addition, they possess a tendotoxic potential. Since ciprofloxacin has been used off-label for decades in children and adolescents, it is known today that no pronounced risks for arthropathies or tendinopathies exist in humans. Recently published clinical studies with gatifloxacin in children support this clinical experience. However, a low risk for joint disorders cannot be excluded and tendinopathies are a generally accepted rare adverse effect of quinolones at least in adults. Isolated case reports of arthralgia in children following quinolone therapy have been published and in studies with levofloxacin the incidence of musculoskeletal disorders was significantly greater in levofloxacin-treated patients than in control patients treated with comparator antibiotics. As a consequence, only life-threatening infections for which other antimicrobials cannot be used are possible indications for quinolones in children, for example the use of ciprofloxacin in cystic fibrosis patients with a bronchopulmonary exacerbation, chronic suppurative otitis media caused by Pseudomonas sp., complicated urinary tract infections and enteritis caused by invasive multidrug-resistant pathogens (e.g. Salmonella, Shigella).

Authors+Show Affiliations

Institut für Klinische Pharmakologie und Toxikologie, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Berlin, Germany.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

18835137

Citation

Sendzik, Judith, et al. "Quinolone-induced Arthropathy: an Update Focusing On New Mechanistic and Clinical Data." International Journal of Antimicrobial Agents, vol. 33, no. 3, 2009, pp. 194-200.
Sendzik J, Lode H, Stahlmann R. Quinolone-induced arthropathy: an update focusing on new mechanistic and clinical data. Int J Antimicrob Agents. 2009;33(3):194-200.
Sendzik, J., Lode, H., & Stahlmann, R. (2009). Quinolone-induced arthropathy: an update focusing on new mechanistic and clinical data. International Journal of Antimicrobial Agents, 33(3), 194-200. https://doi.org/10.1016/j.ijantimicag.2008.08.004
Sendzik J, Lode H, Stahlmann R. Quinolone-induced Arthropathy: an Update Focusing On New Mechanistic and Clinical Data. Int J Antimicrob Agents. 2009;33(3):194-200. PubMed PMID: 18835137.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quinolone-induced arthropathy: an update focusing on new mechanistic and clinical data. AU - Sendzik,Judith, AU - Lode,Hartmut, AU - Stahlmann,Ralf, Y1 - 2008/10/02/ PY - 2008/08/11/received PY - 2008/08/11/accepted PY - 2008/10/7/pubmed PY - 2009/3/31/medline PY - 2008/10/7/entrez SP - 194 EP - 200 JF - International journal of antimicrobial agents JO - Int J Antimicrob Agents VL - 33 IS - 3 N2 - Quinolones possess favourable antibacterial and pharmacokinetic characteristics and are often used as anti-infective agents in adults. They are contraindicated in children and adolescents because they damage weight-bearing joints in juvenile animals. In addition, they possess a tendotoxic potential. Since ciprofloxacin has been used off-label for decades in children and adolescents, it is known today that no pronounced risks for arthropathies or tendinopathies exist in humans. Recently published clinical studies with gatifloxacin in children support this clinical experience. However, a low risk for joint disorders cannot be excluded and tendinopathies are a generally accepted rare adverse effect of quinolones at least in adults. Isolated case reports of arthralgia in children following quinolone therapy have been published and in studies with levofloxacin the incidence of musculoskeletal disorders was significantly greater in levofloxacin-treated patients than in control patients treated with comparator antibiotics. As a consequence, only life-threatening infections for which other antimicrobials cannot be used are possible indications for quinolones in children, for example the use of ciprofloxacin in cystic fibrosis patients with a bronchopulmonary exacerbation, chronic suppurative otitis media caused by Pseudomonas sp., complicated urinary tract infections and enteritis caused by invasive multidrug-resistant pathogens (e.g. Salmonella, Shigella). SN - 1872-7913 UR - https://www.unboundmedicine.com/medline/citation/18835137/Quinolone_induced_arthropathy:_an_update_focusing_on_new_mechanistic_and_clinical_data_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0924-8579(08)00353-1 DB - PRIME DP - Unbound Medicine ER -