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Are quinolone drugs safe for children?

Q: My child (3 years old girl) has diarrhoea. The local paediatrician prescribed Nor Metrogyl (Norfloxacin + Metronidazole). But one of my friends told me that quinolones are not good for children. Is this true? If so what should be given to her? She complains of severe pain and then goes to pass stools. She has this problem since the past two days.

A:Nor Metrogyl is an irrational fixed-dose combination of metronidazole and norfloxacin. Such a combination is not allowed to be sold anywhere in the world. Due to lax functioning of the drug control system in India such dangerous, irrational products continue to be sold and some doctors either because of ignorance or incompetence or misinformation or inducements prescribe such products. The Drugs Controller General of India (DCGI) has contraindicated the use of norfloxacin (and other similar floxacins) in pre-pubertal children (usually below 16 years) because it can damage the growth of bone structure. The Allahabad High Court has fined two doctors with Rs. 300,000 for using a quinolone in a child of 8 years who later developed defects in his legs. Diarrhoea (like fever) is not a disease but a symptom. The cause of diarrhoea (whether viral, bacterial or protozoal) must be determined before giving any medicine. Norfloxacin is an antibacterial while metronidazole is an anti-protozoal. Most cases of diarrhoea in India are due to enteroviruses and hence need no medication, except fluids.

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