The American Academy of Pediatrics (AAP) Infectious Diseases Committee concluded that the use of fluoroquinolones in children should continue to be limited only to infections for which there are no other effective treatment options and safe.

In a review published in the September issue of Pediatrics, fluoroquinolones can be considered in a number of situations as the preferred choice of children, but physicians should be aware of the potential side effects of the drugs.

Experimental data indicate damage to the joints when using these drugs in immature animals. This fact limits the widespread use of fluoroquinolones in children.

At present, data on the duration of the effect of fluoroquinolones on children's bones or joints are insufficient. However, the current U.S. Food and Drug Administration (FDA) analysis of ciprofloxacin safety data, as well as analysis of safety assessment data obtained during the 12-month follow-up period months after the use of levofloxacin, indicate the possibility of an increased development of adverse events with side of the musculoskeletal system in children receiving fluoroquinolones, compared to patients who have been prescribed antimicrobial drugs from other groups.

Nevertheless, the approved indications for the use of fluoroquinolones are developing and specific recommendations on a certain number of nosological forms are specified in the review.

For example, several topical dosage forms of phthoquinolones are approved in the United States for the treatment of acute conjunctivitis in children older than 12 months. For the treatment of otorrhea associated with the use of tympanostomy tubes, the topical use of fluoroquinolones is indeed a safer alternative to drugs containing aminoglycosides.

Undoubtedly, fluoroquinolones are effective in the treatment of respiratory infections in children, but their use is not recommended according to these indications due to the availability of safer drugs.

Cephalosporins remain the standard treatment for urinary tract infections in children. However, in some cases, fluoroquinolones may be considered drugs for the treatment of complicated urinary tract infections or pyelonephritis, when the use of standard antibiotics for the treatment of urinary tract infections is impractical (for example , due to the resistance of pathogens to them).