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氟喹诺酮具有良好的组织渗透性和优秀的抗菌活性,是一类广泛应用于成人患者的重要抗菌药。鉴于这类药物对幼龄动物可诱发产生关节毒性,故一直未被批准用于儿科领域(除严格限于治疗假单胞菌感染引起的儿童囊性纤维化外)。尽管如此,在其他疗法失败时,氟喹诺酮仍被广泛应用于儿科。其中,环丙沙星在儿科的使用率远远高于其他氟喹诺酮,因此,目前氟喹诺酮在儿科领域应用的有关资料主要是关于环丙沙星的。从目前所能收集到的资料分析,氟喹诺酮诱发关节不良反应的发生率主要与患者的年龄相关,成人和儿童分别约为0.1%和2%～3%。氟喹诺酮在儿科领域除用于治疗囊性纤维化外,还被用于治疗其他疗法难以对付的重度感染,如伤寒发热、志贺菌性痢疾和肠杆菌脑膜炎。氟喹诺酮对这些感染疗效确切,且具有疗程短及口服方便等常规疗法无可比拟的优越性。氟喹诺酮也被应用于治疗儿童呼吸道感染、中耳炎等,这样广泛使用的结果不仅可能会给儿科患者带来关节并发症的危险,还可能造成多重耐药菌在社区内传播和蔓延的严重危险。
Fluoroquinolones have good tissue permeability and excellent antibacterial activity, and are a class of important antibacterials widely used in adult patients. Since these drugs can induce joint toxicity in young animals, they have not been approved for use in the pediatric field (except strictly limited to the treatment of Pseudomonas infection in children with cystic fibrosis). Nonetheless, fluoroquinolones are still widely used in pediatrics when other therapies fail. Among them, ciprofloxacin in pediatric use rate is much higher than other fluoroquinolones, therefore, the current application of fluoroquinolones in pediatrics is mainly related to ciprofloxacin. From the data collected so far, the incidence of fluoroquinolone-induced joint adverse reactions is mainly related to the patient’s age, about 0.1% and 2% to 3% for adults and children respectively. In addition to the treatment of cystic fibrosis, fluoroquinolones are also used in the pediatric field to treat severe infections refractory to other therapies, such as typhoid fever, Shigella dysentery and Enterobacter meningitis. Fluoroquinolones treatment of these infections has the exact effect, and has short treatment and oral convenience and other conventional therapies unparalleled superiority. Fluoroquinolones have also been used to treat childhood respiratory infections, otitis media, etc. Such widespread use of results may not only pose a risk of joint complications to pediatric patients but may also pose a serious risk of multi-drug resistant bacteria spreading and spreading within the community.