Clinical Microbiology and Antimicrobial Chemotherapy.2004; 6(4):377-393
The usage of quinolones and fluoroquinolones (FQ) in children and adolescents as well as in pregnant women is considered in this paper. Based on joint toxicity of FQ observed in immature animals this class of antimicrobial agents is officially contraindicated in children. Since the 1986–88s clinical data on efficacy and safety of ciprofloxacin, ofloxacin, and pefloxacin demonstrate that these agents could be used for the treatment of severe bacterial infections in children and adolescents caused by multidrug resistant but susceptible to FQ microorganisms, and refractory to standard antimicrobial regimens. In general, FQ antimicrobials are well tolerated in children and the risk for adverse events, such as joint toxicity, is low. Both short- and long-term administration of fluoroquinolones have shown not to affect cartilages, bones and joints, as well as child growth and development. There were no cases of tendinitis in children treated with FQ. Author highlight that the use of fluoroquinolones should be limited to infections refractory to other antimicrobials that approved for children and adolescents. There is a need to develop special guidelines for the possible use of FQ in children and adolescents. A number of data published on the FQ use for the life-saving treatment in pregnancy with no cases of adverse effect on fetus and child development.