According to a study by Canadian scientists, the incidence of joint and tendon adverse drug reactions (NLR) when using fluoroquinolones in children is no higher than when prescribing azithromycin.

To assess the frequency and relative risk of developing arthro- and tendopathies associated with the use of fluoroquinolones and azithromycin, the authors conducted an observational retrospective cohort study. As an initial source of information, the requirements of pharmacies for the delivery of ofloxacin, levofloxacin, ciprofloxacin and azithromycin to patients under 19 years of age were used. 7897 patients in this age group who received one of the drugs from the fluoroquinolone group were identified, and a comparison cohort corresponding to the first group by sex and by age composition, to which azithromycin (from a total population of more than 20,000 patients) has been selected, has been selected. After exclusion from the study of children whose medical documentation was not available, as well as patients with the initial pathology of the joints and tendons, an analysis of 257 cases was carried out, of which 168 were verified by a medical examination.

The frequency of verified cases of tendo- or arthropathy in children receiving azithromycin, ofloxacin or ciprofloxacin was 0.78%, 0.82% and 0.82%, respectively; in 16 children for whom levofloxacin was prescribed, there was no development of tendon or joint damage. The risk ratios for NLR of the joints and tendons when using fluoroquinolones compared to azithromycin were close to unity in all cases, with no significant differences by sex and age.

The results of the study allow us to conclude that the incidence of NLR from the joints and tendons with the use of fluoroquinolones in children is low and does not differ from that of treatment with azithromycin. However, the authors point out that most of the children in this study who received fluoroquinolones were over 10 years of age. Therefore, it is possible that in young children, the risk of arthro- and tendopathy during treatment with fluoroquinolones is higher, which requires further study.