Background In our hospital, the consumption of fluoroquinolone (FQ) antibiotics has increased since 2004. Moreover, the development of quinolone-resistant strains of Escherichia coli and their spread have become a worrying issue. The FQs available in our hospital are norfloxacin (Nor), ofloxacin (Oflo), ciprofloxacin (Cip), levofloxacin (Levo). Cip and Levo access are restricted by the hospital formulary. The Antimicrobial MultiDisciplinary Team (AMDT), composed of the pharmacy resident and a clinical microbiologist, reviews all prescriptions daily before dispensing.
Purpose To assess the relevance of FQ prescriptions in the department of Internal Medicine and then to initiate a thoughtful consideration of non-restricted fluoroquinolones.
Materials and Methods Over a six-month period, all cases of FQ prescriptions for acute infections were analysed by both a pharmacy resident and a bacteriologist. Appropriateness of prescriptions was determined by using a therapeutic suitability index, which investigated relevance of FQ and drug prescribed, dosage adjustments, duration of treatment and route of administration.
Results Forty-three prescriptions were assessed. Ofloxacin was the most prescribed FQ representing 72% of the prescriptions, followed by ciprofloxacin (16%), levofloxacin (7%) and norfloxacin (7%). Fewer than 33% of prescriptions adhered to guidelines for all items. Another antibacterial family should have been prescribed in 11% of cases (3 Oflo and 2 Nor). The drug prescribed was judged debatable in 25% of cases (9 Oflo and 2 Cip). Dosage was not adapted to renal function in 4 prescriptions. Route of administration was justified for all prescriptions.
Conclusions These results were presented to the antibiotic control committee. Because of the overuse and misuse of ofloxacin, it has been decided to restrict its access, which will lead to improve quality of fluoroquinolone usage.
No conflict of interest.
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