Critical risk/benefit analysis of pefloxacine use in children under 15 years--the problem of arthralgias

Abstract

Pefloxacine belongs to a group of new quinolone antibiotics with more general indications than the urinary quinolones marketed about twenty years ago. The contraindication of the quinolones in children under 15 years of age limits their usage exclusively to adults. In this paper, the adverse arthralgic effects of these quinolones, which have largely motivated the contraindication, have been analyzed from an experimental, clinical and pathophysiological point of view. It is concluded that the pediatric benefits associated with the marked antibacterial activity of pefloxacine, particularly in pseudomonas and enterobacteriae infections, should be balanced against the risks associated with arthralgia whenever the condition of the patient is grave and decisions vital to a favorable prognosis for the sick child are necessary.