The incidence of teno- and arthropathy in children after treatment with fluoroquinolones and azithromycin is also low

Fluoroquinolones are rarely used in children. This is mainly due to the fact that antimicrobial agents in this group can damage cartilage in growing animals. However, it is still not known whether fluoroquinolones in children cause such disorders.

To assess the frequency and relative risk of teno- and arthropathy, which may develop after the use of fluoroquinolones compared to azithromycin (a medicine where no side effects are associated with the effects on cartilage and tendons in humans or animals), a retrospective observational study was conducted by American researchers.

To identify patients under the age of 19 who received ofloxacin, levofloxacin, ciprofloxacin or azithromycin, a search was performed in an automated database. Potential cases of tendo- and arthropathy have been identified which occurred within 60 days of starting treatment with any of the above drugs.

It was found that the incidence of teno- and arthropathy was 0.82% when using ofloxacin (13 cases out of 1593 prescriptions) and ciprofloxacin (37 cases out of 4531) and 0.78% when using azithromycin (118 cases out of 15073). The relative risk of developing teno- and arthropathies with ofloxacin and ciprofloxacin compared to azithromycin was 1.04 (95% confidence interval - CI, 0.55 - 1.84) and 1, 04 (95% CI, 0.72 - 1.51), respectively. The prevalence of this pathology and its appearance were comparable in all the groups studied. Joint damage has been reported most often, followed by tendon, cartilage and gait disorders.

Thus, in this observational study, which analyzed the treatment results for more than 6000 children treated with fluoroquinolones, the incidence of teno- and arthropathies associated with the use of this group of drugs was less than 1% and was comparable how often these adverse events develop in children who have been prescribed azithromycin.