158. The Use and Safety of Ciprofloxacin in Korean Children: A Retrospective Multicenter Study
Session: Poster Abstract Session: Antimicrobial Use in Children
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • IDWeek 2013_Poster No.158.pdf (224.3 kB)
  • Background:

    Ciprofloxacin is not approved in children under 18 years old due to its potential musculoskeletal adverse effects. However, it is widely prescribed in the pediatric patients. We conducted a retrospective multicenter study to evaluate the prescription pattern of ciprofloxacin and to review any reported adverse events in Korean children.

    Methods:

    A retrospective review was performed in patients younger than 18 years old who received ciprofloxacin in 7 university hospitals in Korea from January 2006 to December 2011.  

    Results:

    A total of 729 patients were identified. The median age was 15.9 years (range, 0.1-17.9); 18 patients (2.5%) were under 2 years old, 77 (10.6%) 2-9 years, 143 (19.6%) 10-14 years, and 491 (67.4%) 15-17 years. Two-hundred sixty-nine (36.9%) patients had comorbid medical conditions. Ciprofloxacin was given as the first-line antimicrobial agent in 480 (65.8%) patients. Clinical diagnoses at the time of ciprofloxacin prescription were gastroenteritis (325, 44.6%), urinary tract infections (159, 21.8%), abscess or skin and soft tissue infections (65, 8.9%) and pneumonia (55, 7.5%). There were 22 bacteremia cases (3.0%). Ciprofloxacin was prescribed mostly by emergency care physicians (207, 28.4%), internal medicine physicians (187, 25.7%) and pediatricians (153, 21.0%). The use of ciprofloxacin based on culture results was observed in only 26.1% of total patients (190/729); 43.8% by pediatricians vs. 21.4% by non-pediatric physicians (P<0.0001). Adverse events after use of ciprofloxacin were observed in 15 patients (2.1%): four with hypersensitivity, six with gastrointestinal complaints, one with headache, one with EKG abnormality and three others.  There was no musculoskeletal complication reported.

    Conclusion:

    This is the first multicenter study to evaluate the prescription pattern and safety of ciprofloxacin in Korean children. We found that ciprofloxacin was frequently prescribed in children as an empiric antibiotic choice in many unapproved indications and musculoskeletal adverse event was not reported in any of these patients. There is a need for systematic monitoring for the appropriate use of ciprofloxacin and development of musculoskeletal complication in Korean children.

    Soo-Han Choi, MD1,2, Yanghyun Kim, RN1, Eun Young Kim, PhD3, Wonku Kang, PhD4, Byung-Kee Lee, MD5, Soo Jin Kim, MD5, Eun Hwa Choi, MD, PhD6, Hoan Jong Lee, MD, PhD, FIDSA6, Ki Hwan Kim, MD, PhD7, Dong Soo Kim, MD, PhD7, Byung Wook Eun, MD, PhD8, Dae Sun Jo, MD, PhD9, Jong-Hyun Kim, MD, PhD10, Su Eun Park, MD, PhD11 and Yae-Jean Kim, MD, PhD5, (1)Center for Clinical Research, Samsung Biomedical Research Institute, Seoul, South Korea, (2)Department of Pediatrics, Korea Electric Power Corporation Medical Foundation, Kepco Medical Center, Seoul, South Korea, (3)Department of Clinical Pharmacy, College of Pharmacy, Chungang University, Seoul, South Korea, (4)College of Pharmacy, Yeungnam University, Gyeongsan, South Korea, (5)Department of Pediatrics, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea, (6)Department of Pediatrics, Seoul National University Childrenís Hospital, Seoul, South Korea, (7)Department of Pediatrics, Severance Childrenís Hospital, Yonsei University College of Medicine, Seoul, South Korea, (8)Department of Pediatrics, Eulji University School of Medicine, Eulji General Hospital, Seoul, South Korea, (9)Department of Pediatrics, Chonbuk National University Medical School, Jeonju, South Korea, (10)Department of Pediatrics, St. Vincentís Hospital, College of Medicine, The Catholic University of Korea, Suwon, South Korea, (11)Department of Pediatrics, College of Medicine, Pusan National University, Busan, South Korea

    Disclosures:

    S. H. Choi, None

    Y. Kim, None

    E. Y. Kim, None

    W. Kang, None

    B. K. Lee, None

    S. J. Kim, None

    E. H. Choi, None

    H. J. Lee, None

    K. H. Kim, None

    D. S. Kim, None

    B. W. Eun, None

    D. S. Jo, None

    J. H. Kim, None

    S. E. Park, None

    Y. J. Kim, None

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