Fluoroquinolones in children: poorly defined risk of joint damage.

(1) Rare but well-documented cases of joint damage, with no other identified cause, have been reported in children treated with systemic fluoroquinolones. The joint damage usually resolves gradually after drug withdrawal and are more frequent with pefloxacin. (2) The few available paediatric trials included too few patients to identify rare adverse effects on joints, or to show a causal relationship between treatment and joint damage. (3) In practice, quinolones are an option for children only when the expected benefit outweighs the risk of joint damage. In the rare cases in which fluoroquinolone therapy is justified, ciprofloxacin is the drug of first choice. Pefloxacin should be avoided.