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Do fluoroquinolones commonly cause arthropathy in children?

Published online by Cambridge University Press:  21 May 2015

Clinton T. Forsythe
Affiliation:
University of Minnesota Medical Centre, Fairview, Minn.
Michael E. Ernst*
Affiliation:
Division of Clinical and Administrative Pharmacy, College of Pharmacy and the Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
*
Department of Family Medicine/01291-A PFP, University of Iowa, 200 Hawkins Drive, Iowa City IA 52242; michael-ernst@uiowa.edu

Abstract

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Objective:

The objective of this paper was to review the relation between fluoroquinolone (FQ) use and arthropathy in children.

Methods:

The biomedical literature from January 1980 to February 2007 was searched using PubMed. Key search terms included fluoroquinolones, arthropathy, tendinopathy and children. Literature was included if it was a clinical trial or meta-analysis examining the use of 1 or more FQs in a pediatric human population and if it had a primary outcome measure of reported incidence of arthropathy or tendinopathy. Articles were excluded if the primary outcome measure was efficacy of an FQ in a particular pediatric disease state, and evaluated safety was a secondary end point.

Results:

Data was reviewed from 4 large retrospective studies. Three of the 4 studies failed to find a significant link between musculoskeletal injury and FQ treatment. One study reported a correlation between use of pefloxacin and arthropathy, but the authors' conclusions supported the use of FQs in select pediatric cases.

Conclusion:

Arthropathy that occurs as a result of FQ use in children has not been adequately supported by published data from safety trials in human children. Concerns about arthropathy with FQs should not preclude their use by emergency physicians when appropriate and necessary in pediatric patients.

Type
Original Research • Recherche originale
Copyright
Copyright © Canadian Association of Emergency Physicians 2007

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