PMID- 29939314
OWN - NLM
STAT- MEDLINE
DCOM- 20181113
LR  - 20220409
IS  - 2048-7207 (Electronic)
IS  - 2048-7193 (Linking)
VI  - 7
IP  - 3
DP  - 2018 Aug 17
TI  - Safety and Tolerability of Moxifloxacin in Children.
PG  - e92-e101
LID - 10.1093/jpids/piy056 [doi]
AB  - OBJECTIVES: Moxifloxacin is not approved by the US Food and Drug Administration 
      for pediatric use. Although its use might be indicated under certain conditions, 
      data regarding its safety and tolerability in pediatric patients are limited. The 
      primary objective of this study was to evaluate the safety of systemic 
      moxifloxacin therapy in children. METHODS: We conducted a retrospective 
      observational study of patients aged <18 years who received oral or intravenous 
      moxifloxacin at our institution between January 2011 and July 2016. Patient 
      demographics, clinical characteristics, indication for moxifloxacin use, and 
      adverse events (AEs) were extracted via chart review. The attribution of AEs to 
      moxifloxacin use was adjudicated in consultation with a pediatric infectious 
      disease (ID) pharmacist. RESULTS: We identified 221 patients who received 300 
      courses of moxifloxacin. The average age at moxifloxacin initiation was 10.4 
      years. One or more AEs occurred during 195 (65%) of the courses. Of the 463 
      distinct AEs, 46 (9.9%) were attributed to moxifloxacin. AEs attributed to 
      moxifloxacin included corrected QT interval (QTc) prolongation (18 [6%] courses), 
      transaminase level elevation (7 [2.3%] courses), and increased bilirubin level (3 
      [1%] courses). AEs led to moxifloxacin discontinuation in 18 (6%) courses. ID 
      consultation was associated with QTc (P < .001) and transaminase (P = .002) 
      monitoring. CONCLUSIONS: AEs that occur during pediatric moxifloxacin therapy are 
      relatively common but rarely serious enough to require premature discontinuation. 
      The drug might be used safely in most children with monitoring, including 
      evaluation for QTc prolongation, and guidance from ID specialists.
FAU - Dixit, Avika
AU  - Dixit A
AD  - Division of Infectious Diseases, Boston Children's Hospital, Massachusetts.
AD  - Harvard Medical School, Boston, Massachusetts.
FAU - Karandikar, Manjiree V
AU  - Karandikar MV
AD  - Division of Infectious Diseases, Boston Children's Hospital, Massachusetts.
AD  - Harvard Medical School, Boston, Massachusetts.
FAU - Jones, Sarah
AU  - Jones S
AD  - Division of Infectious Diseases, Boston Children's Hospital, Massachusetts.
AD  - Department of Pharmacy, Boston Children's Hospital, Massachusetts.
FAU - Nakamura, Mari M
AU  - Nakamura MM
AD  - Division of Infectious Diseases, Boston Children's Hospital, Massachusetts.
AD  - Harvard Medical School, Boston, Massachusetts.
AD  - Division of General Pediatrics, Boston Children's Hospital, Massachusetts.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - England
TA  - J Pediatric Infect Dis Soc
JT  - Journal of the Pediatric Infectious Diseases Society
JID - 101586049
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Fluoroquinolones)
RN  - EC 2.6.1.1 (Aspartate Aminotransferases)
RN  - EC 2.6.1.2 (Alanine Transaminase)
RN  - RFM9X3LJ49 (Bilirubin)
RN  - U188XYD42P (Moxifloxacin)
SB  - IM
MH  - Administration, Intravenous
MH  - Administration, Oral
MH  - Adolescent
MH  - Alanine Transaminase/blood/drug effects
MH  - Anti-Bacterial Agents/*adverse effects/*therapeutic use
MH  - Aspartate Aminotransferases/blood/drug effects
MH  - Bacterial Infections/blood/*drug therapy/enzymology
MH  - Bilirubin/blood
MH  - Blood Cell Count
MH  - Child
MH  - Child, Preschool
MH  - Drug Administration Schedule
MH  - Female
MH  - Fluoroquinolones/*adverse effects/*therapeutic use
MH  - Humans
MH  - Infant
MH  - Long QT Syndrome/chemically induced
MH  - Male
MH  - Moxifloxacin
MH  - Neutropenia/chemically induced
MH  - Retrospective Studies
MH  - Seizures/chemically induced
EDAT- 2018/06/26 06:00
MHDA- 2018/11/14 06:00
CRDT- 2018/06/26 06:00
PHST- 2018/01/11 00:00 [received]
PHST- 2018/06/07 00:00 [accepted]
PHST- 2018/06/26 06:00 [pubmed]
PHST- 2018/11/14 06:00 [medline]
PHST- 2018/06/26 06:00 [entrez]
AID - 5043489 [pii]
AID - 10.1093/jpids/piy056 [doi]
PST - ppublish
SO  - J Pediatric Infect Dis Soc. 2018 Aug 17;7(3):e92-e101. doi: 10.1093/jpids/piy056.