Ciprofloxacin safety in paediatrics: a systematic review

Adefurin A, Sammons H, Jacqz-Aigrain E, Choonara I · Archives of Disease in Childhood

Musculoskeletal adverse events (mainly arthralgia/arthropathy) occurred in 1.6% (95% CI 0.9–2.6%), with onset a median 6 days into treatment; pooled controlled studies gave OR 1.57 (1.26–1.97) against comparators, and six cystic-fibrosis patients had MRI-confirmed cartilage changes. All cases with a recorded outcome resolved or improved (one arthralgia was reported unchanged with no management recorded), over follow-up of 1 week to 50 months — the juvenile-animal chondrotoxicity has not translated into documented permanent human cartilage injury.

Population

16,184 paediatric patients across 105 studies of ciprofloxacin use

Intervention

Ciprofloxacin

Comparator

Varies by included study

Limitations

Adverse-event ascertainment varied; only 10 of 32 arthropathy-reporting studies gave onset, follow-up and management detail; no imaging or long-term cartilage follow-up in most studies; cannot exclude subclinical effects. Funded by the European Commission's FP7 TINN project; no competing interests.