Fluoroquinolones are contraindicated in children and pregnant women primarily because of:

• A Teratogenic effects on fetal CNS development
• B QTc prolongation that is more pronounced in the immature myocardium
• C Competitive inhibition of folic acid synthesis in rapidly dividing fetal cells
• D Damage to weight-bearing cartilage (arthropathy) in immature animals, and risk to fetus ✓

Explanation

Fluoroquinolones inhibit bacterial topoisomerases II and IV, but at high concentrations they also inhibit mammalian topoisomerases in rapidly proliferating cells. In animal studies, fluoroquinolones have been shown to cause erosion of immature articular cartilage in weight-bearing joints, a finding that raised safety concerns for children and adolescents. Although conclusive human data showing the same effect is limited, the class is generally avoided in patients under 18 years and in pregnancy. They are used in children only when no suitable alternative exists (e.g., certain pseudomonal infections in cystic fibrosis).

Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.