Ciprofloxacin use: acute arthropathy and long-term follow up.

OBJECTIVE To assess whether children treated with ciprofloxacin in 1990 had developed any permanent joint damage. DESIGN Retrospective questionnaire-based follow-up study. SETTING Adverse Drug Reaction (ADR) Monitoring Center in Mumbai. SUBJECTS 3341 children treated with ciprofloxacin in 1990, including 7 who had developed a ciprofloxacin-related acute arthropathy. METHODS A questionnaire was sent in January 1995 to 147 pediatricians who had reported to us children in whom ciprofloxacin was prescribed in 1990. The information sought for included the number of children who had followed-up beyond 2 years and details of any joint-related complaints noted in them on long-term follow-up. RESULTS Long-term follow-up was reported in 582 of these 3341 children. No joint-related complaints had developed in 581 children, either as an acute ADR in 1990 or as a delayed ADR during a minimum follow-up period of 2 years. Long-term follow-up was available in only 1 of the 7 children in whom a ciprofloxacin-related acute arthropathy had developed in 1990, and this child was now asymptomatic. New information was received about 13 children treated with ciprofloxacin during 1991-1994 who had developed a ciprofloxacin-related acute arthropathy. In the total 20 children, aged 2-12 years, reported to us for acute ADR, the arthropathy (joint pains, restriction of joint movements and/or swelling of joint) had developed on day 1 to 8 of ciprofloxacin therapy, and in 18 the acute arthropathy had resolved within 1 day to 4 weeks of either discontinuing or completing ciprofloxacin therapy. Outcome in the remaining 2 children was not available. CONCLUSIONS Ciprofloxacin use can cause an acute reversible arthropathy, but in this study there is no evidence that its use can cause a delayed arthropathy or any permanent joint damage.