Objective To assess the potential of ciprofloxacin to induce arthropathy in children and provide evidence for clinical practice. Methods We searched MEDLINE(1985- March 2006), The Cochrane Library (Issue 1,2006), EMBASE(1985 to March 2006) and CBMdisk(1990 to March 2006) for randomized controlled trials (RCTs) involving the safety of ciprofloxacin in pediatrics. We assessed the methodological quality of the studies identified. RevMan 4.2 was used for meta-analysis. Results Seven RCTs met the inclusion criteria. Compared with the control group, the combined rate of arthralgia did not increase compared to ciprofloxacin. The relative risk was 0.98, 95% confidence interval 0.65 to 1.48. No studies reported joint pathology and cartilage lesions on radiographic imaging, ultrasound or magnetic resonance imaging in the pediatric population. Conclusion Based on the results of the review and the meta-analysis, there is no evidence that using ciprofloxacin in the pediatric population is associated with clinical arthropathy. Further well-designed clinical studies should be performed to assess the long-term consequences of the use of ciprofloxacin in children.
