Douidar S M, Snodgrass W R
Department of Pediatrics, University of Texas Medical Branch, Galveston 77550.
Rev Infect Dis. 1989 Nov-Dec;11(6):878-89. doi: 10.1093/clinids/11.6.878.
The fluoroquinolones are new, broad-spectrum, bactericidal antimicrobial agents structurally related to nalidixic acid. They are well absorbed after oral administration, with serum and tissue levels generally in excess of the minimal inhibitory concentrations for susceptible organisms. Their spectrum of activity includes serious pediatric pathogens such as Haemophilus influenzae, Pseudomonas aeruginosa, and methicillin-resistant Staphylococcus aureus. The potential uses of fluoroquinolones in pediatric diseases include acute and chronic pulmonary infections in children with cystic fibrosis, methicillin-resistant staphylococcal infections, meningitis with resistant bacteria, and prophylaxis in leukemic and immunocompromised children. The toxicity of some quinolone derivatives that involve developing cartilage in sensitive animal species has to be studied further. Clinical trials of fluoroquinolones from Europe and the United States in children show no cartilage or joint toxicity. For the time being and until more clinical experience with fluoroquinolones in children is obtained, their use should be limited to specific cases of therapeutic failure or multiple resistance to other antibiotics.
氟喹诺酮类是一类新型的、广谱的、杀菌性抗菌药物，其结构与萘啶酸相关。口服后吸收良好，血清和组织水平通常超过对敏感菌的最低抑菌浓度。它们的活性谱包括严重的儿科病原体，如流感嗜血杆菌、铜绿假单胞菌和耐甲氧西林金黄色葡萄球菌。氟喹诺酮类在儿科疾病中的潜在用途包括囊性纤维化患儿的急慢性肺部感染、耐甲氧西林葡萄球菌感染、耐药菌引起的脑膜炎，以及白血病和免疫功能低下儿童的预防用药。一些喹诺酮衍生物对敏感动物物种软骨发育的毒性还有待进一步研究。欧洲和美国针对儿童的氟喹诺酮类临床试验显示无软骨或关节毒性。目前，在获得更多关于儿童使用氟喹诺酮类的临床经验之前，其使用应限于治疗失败的特定病例或对其他抗生素多重耐药的情况。
