Active Ingredient: Ciprofloxacin
The records of 61 of our previous 68 patients who underwent surgery and were hospitalized and treated with an intravenous extended-spectrum penicillin and gentamicin for six to eight weeks, were analyzed.
Twenty-one of 23 patients treated with ciprofloxacin were cured; therapy failed in two patients.
Treatment averaged 16. Higher fluoroquinolone doses produce more extensive articular damage. Clinically, the fluoroquinolone-associated cartilage toxicity in animal models has mainly been seen in large, weight-bearing joints. Affected dogs become lame, with sporadic synovial effusion after 1—7 days of quinolone treatment.
In addition, affected dogs exhibit an altered standing posture characterized by hyperextension of weight-bearing joints. Histopathologic damage, such as blisters, fissures, and erosions accompanied by joint effusions, and MRI abnormalities are correlated with clinical findings.
This population would clearly benefit from greater availability of an inexpensive, effective gonorrhea treatment but are restricted from the use of fluoroquinolones because of a theoretical risk of associated cartilage toxicity observed in animals.
We found 69 references.
We limited the search to articles concerning human subjects in English, French, or German. This reduced the number of citations to 14.
We obtained an additional 17 citations from article references that had not been identified by the original search.
We included studies that provided data on the adverse effects of fluoroquinolone use in adolescents through their mid-20 s.
We summarized articles and recorded information on evaluation methodology, subject age, diagnoses, results, and study conclusions.
Length of fluoroquinolone exposure and duration of follow-up were presented in months.
We drew conclusions on the basis of evidence from the literature for future changes in recommendations of adolescent fluoroquinolone use for the treatment of gonorrhea infection.
Results Studies with histopathologic or radiological end points. We reviewed 10 studies that, radiographically or pathologically by autopsy, evaluated pediatric and adolescent patients aged 5 days—24 years who were treated with ciprofloxacin or ofloxacin for 7 days—10 months.
These studies found no evidence of the cartilaginous pathology described in the original fluoroquinolone animal studies table 1.
Limitations of the studies reviewed risk sensitivity of methods used to treat cartilage damage.
Mulama. Metabolic status to simultaneously activate anthocyanin and proanthocyanidin biosynthetic bones in Nicotiana spp.