CHONDROTOXICITY OF FLUOROQUINOLONES IN CHILDREN: YES OR NO?

• Published in: Bezopasnostʹ i risk farmakoterapii (Online) no. 2; pp. 40 - 47
• Main Authors: S. S. Postnikov, S. Y. Semykin, V. P. Nazhimov, A. I. Kamenev
• Format: Journal Article
• Language: Russian
• Published: Ministry of Health of the Russian Federation, Federal State Budgetary Institution «Scientific Centre for Expert Evaluation of Medicinal Products 01.02.2018
• Subjects: aplastic avemia; arthrotoxicity; children; chondral morphology; cystic fibrosis; fluoroquinolones accumulation; linear growth; monofluoroquinolones; апластическая анемия; артротоксичность; дети; кумуляция фторхинолонов; линейный рост; монофторхинолоны; морфология хряща; муковисцидоз
• ISSN: 2312-7821; 2619-1164

Two groups of children on therapy with monofluoroquinolones were enrolled in this open research trial: 169 patients with cystic fibrosis (exacerbation period) and 55 patients with aplastic anemia (neutropenic phase); age was from 6 months to 16 years. The aim of the study was to compare tolerability (with the focus on arthrotoxicity) of ciprofloxacin, ofloxacin and pefloxacin during intermittent (15-50 mg/kg/day in cystic fibrosis patients) and prolonged continuous therapy (10-15 mg/kg/day in patients with aplastic anemia). Quinolone-induced arthropathy was reported in 7, 6% of all cases, mainly during pefloxacin therapy (31, 8%), and more frequently in patients with aplastic anemia (10, 9% vs. 7, 7%), only in pubertal children, and was fully reversible with no influens on the lineal growth. Following the monofluoroquinolones use, residual joint-related symptoms were not observed because monofluoroquinolones did not achieve chondrotoxic concentrations in cartilaginous structures.