Oral ciprofloxacin in the treatment of Pseudomonas exacerbations of paediatric cystic fibrosis: Clinical efficacy and safety evaluation using magnetic resonance image scanning

Ciprofloxacin is effective for treating pulmonary infection in adult cystic fibrosis patients, and demonstrates excellent efficacy against Pseudomonas aeruginosa, but its use in paediatric cystic fibrosis patients has been li mited because quinolone-induced cartilage toxicity has been observed in juv enile animals and has been considered a potential risk for children. Childr en with cystic fibrosis (n = 26; aged 6 - 16 years), with proven P. aerugin osa colonization of their sputum, were enrolled into a 14-day, open, non-co mparative study. Patients were assigned to twice-daily treatment with oral ciprofloxacin 250 mg, 500 mg or 750 mg, depending on their body weight. Non e of the patients exhibited any signs or symptoms of arthropathy, as assess ed by magnetic resonance imaging of the right knee, during or immediately a fter treatment, or at the 3-month post-therapy assessment. Cough, sputum pr oduction and sputum purulence were improved in more than 70% of patients. P atients showed a mean weight increase of 0.4 kg (95% confidence interval 0. 1 to 0.7 kg) over the study period. Only one patient required a repeat ches t radiograph, which showed no resolution of the abnormal radiographic appea rances. Three patients reported adverse events during the trial, none of wh ich were considered to be related to the study treatment.