Prescribing pattern of fluoroquinolone antibiotics in medicine units of rural tertiary care teaching hospital in South India

Author : Bipin Kafle, M. Kumaraswamy, Puskar Kunwor, Jamuna T.R., Nirajan Kunwar, Thakur Pokharel

Background: Fluoroquinolones (FQs) are among the most commonly prescribed antimicrobials and are used inappropriately which may increases the risk of bacterial drug resistance. Objective: To know the utilization pattern of Fluoroquinolones and give a review of the prescribing practice of physicians in rural hospital. Methodology: A hospital based prospective and observational study was carried out in medicine units of tertiary care teaching hospital. The prescription was screened for utilisation of FQs. Results: Among 108 patients, 60 were males and 48 females. Total of 92.59% patients received Fluoroquinolones for empirical treatment. Ciprofloxacin was the most commonly used FQs. An average of 1.06 Fluoroquinolones per prescription was prescribed. Oral route was more preferred than the parenteral route for administration of FQs. Mean SD number of drugs prescribed was 10.10 3.16 and duration of hospitalization was 6.84 3.77 days. Two cases of E. coli were resistance to Ofloxacin and Ciprofloxacin. Total of 72 possible Drug- Drug Interactions (DDIs) were identified in 54 patients. Out of which, 33 (45.83%) were accepted and necessary action was taken to minimize the risk of interaction. Conclusion: The specific use of Fluoroquinolones based on culture test is necessary. The application of stewardship strategies increases physician awareness of guidelines improves appropriate antimicrobial use and reduces unnecessary antimicrobial prescribing. Prescription review by clinical pharmacists with feedback to the prescriber is needed to improve appropriate use of FQs, on time management of possible risk from drug interaction and avoidance of drug resistance.

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