Fluoroquinolones should only be prescribed in certain medical conditions

New Delhi, 23 July 2018: As per a new study, in medical offices and emergency departments, about 5% of all fluoroquinolones prescribed for adults are completely unnecessary. About 20% of all fluoroquinolone prescriptions do not adhere to recommendations about their use as a first-line therapy. The study also indicates that fluoroquinolones are commonly prescribed for conditions when antibiotics are not needed at all.
Based on the FDA’s warning, fluoroquinolones should only be used in patients with acute bacterial sinusitis and bacterial exacerbation of chronic bronchitis, or uncomplicated urinary tract infections in the absence of other treatment options. Prescribing the right antibiotic, at the right dose, for the right duration, and at the right time helps optimize patient care and fight antibiotic resistance.
Speaking about this, Padma Shri Awardee, Dr K K Aggarwal, President, HCFI, said, “There are more than 60 generic versions of fluoroquinolones. There are 5 fluoroquinolones for systemic use in the market: Moxifloxacin, Ciprofloxacin, Gemifloxacin, Levofloxacin and Ofloxacin. These are also anti-TB drugs and if misused can cause drug-resistant TB. Fluoroquinolone should be reserved for those who do not have alternative treatment options. When prescribed for conditions that may not require antibiotic treatment at all, they can cause various side effects including disturbance to attention span, disorientation, agitation, nervousness, memory impairment, and delirium. Misuse and overuse of antibiotics have made once easily treatable bacterial infections harder and often impossible to cure. This phenomenon is on the rise due to their inappropriate use in human medicine.”
It was in 2016 that the FDA accepted the existence of a potentially permanent syndrome that it calls fluoroquinolone-associated disability (FQAD) and recommended that the drugs be reserved for serious infections. Healthcare providers often cite patient satisfaction as a reason for prescribing an antibiotic when none is recommended.
Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “Many bacteria have developed resistance to the so-called ‘wonder drugs’ reducing their effectiveness. The emergence of resistance to antibiotics was perhaps a development ‘waiting to happen’ given their indiscriminate use since they were first discovered. With no new antibiotics in the pipeline, a ‘pre-antibiotic era’ looms ahead, where many common infections might no longer have a cure and, once again, become a threat to human life.”
Some tips from HCFI
• Practice rational use of drugs antibiotics
• Use when needed and according to guidelines
• Avoid broad spectrum antibiotics without appropriate diagnosis
• Prevent infections with the use of vaccination and by improving basic hygiene including hand hygiene and infection control techniques and sanitation in health care settings as well as in the community
• Farmers and food industry must stop using antibiotics routinely to promote growth and prevent disease in healthy animals to prevent the spread of antibiotic resistance.