Table 2.

Clinical Uses for Most Commonly Prescribed Fluoroquinolones in Children

Drug	Pediatric FDA-Approved Indications	Additional Pediatric Clinical Uses	AAP Recommendations
Ciprofloxacin	Inhalation anthrax Complicated urinary tract infection/pyelonephritis	Salmonella typhi infections Shigella dysenteriae Cystic fibrosis exacerbations from Pseudomonas aeruginosa Fever and neutropenia prophylaxis	Exposure to aerosolized Bacillus anthracis UTI caused by P. aeruginosa or other multidrug-resistant, Gram-negative bacteria Chronic suppurative otitis media or malignant otitis externa caused by P. aeruginosa
Levofloxacin	Inhalation anthrax	Acute otitis media Sinusitis Pneumonia Multidrug-resistant tuberculosis	Chronic or acute osteomyelitis or osteochondritis caused by P. aeruginosa Exacerbation of pulmonary disease in patients with cystic fibrosis who are colonized with P. aeruginosa and can be treated as outpatients Mycobacterial infections caused by fluoroquinolone-susceptible isolates
Moxifloxacin	Not indicated	Multidrug-resistant tuberculosis	Gram-negative bacterial infections in immunocompromised hosts in which oral therapy is desired or resistance to alternative agents is present Gastrointestinal tract infections caused by multidrug-resistant Shigella species, Salmonella species, Vibrio cholerae, or Campylobacter jejuni Documented bacterial septicemia or meningitis attributable to organisms with in vitro resistance to approved agents or in immunocompromised infants and children in whom parenteral therapy with other appropriate antimicrobial agents has failed Serious infections attributable to fluoroquinolone-susceptible pathogens in children with a life-threatening allergy to alternative agents