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Journal of General Internal Medicine

, Volume 34, Issue 11, pp 2342–2344 | Cite as

Inappropriate Fluoroquinolone Use in Academic and Non-academic Primary Care Clinics

  • Adrian Brown
  • Jordan R. Wong
  • Sheetal Kandiah
  • Justin Moore
  • Kristi QuairoliEmail author
Concise Research Reports

INTRODUCTION

Within the USA, it is estimated that 30% of outpatient antibiotic prescriptions may be inappropriate.1 In 2016, the Centers for Disease Control and Prevention released the Core Elements of Outpatient Antibiotic Stewardship, which recommended clinicians and facilities perform tracking and reporting of antibiotic prescribing as an initiative to develop outpatient antibiotic stewardship programs (ASPs) and reduce inappropriate antibiotic use.2 Fluoroquinolones are a class of broad-spectrum antibiotics that are over-utilized in the outpatient setting with several recent Food and Drug Administration warnings for serious adverse drug reactions (ADRs).3, 4 An estimated 5.1% and 19.9% of fluoroquinolone prescriptions are for indications not requiring antibiotics or have indications with alternative first-line antibiotics, respectively.5 One study demonstrated 84.0% of outpatient fluoroquinolone prescriptions were inappropriate based on guideline recommendations.6The purpose of...

Notes

Contributors

Department of Pharmacy and Drug Information, Grady Health System

Compliance with Ethical Standards

This study was granted exemption by the Emory University IRB and for this type of study formal consent is not required.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

References

  1. 1.
    Fleming-Dutra KE, Hersh AL, Shapiro DJ, et al. Prevalence of inappropriate antibiotic prescriptions among U.S. ambulatory care visits, 2010-2011. JAMA 2016;315(17):1864–73.CrossRefGoogle Scholar
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    Sanchez, GV, Fleming-Dutra, KE, Roberts, RM, Hicks, LA. Core elements of outpatient antibiotic stewardship. MMWR Recomm Rep 2016;65(No. RR-6):1–12.CrossRefGoogle Scholar
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    U.S. Food and Drug Administration. FDA warns about increased risk of ruptures or tears in the aorta blood vessel with fluoroquinolone antibiotics in certain patients. Available at: https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-about-increased-risk-ruptures-or-tears-aorta-blood-vessel-fluoroquinolone-antibiotics. Accessed April 29, 2019.
  4. 4.
    U.S. Food and Drug Administration. FDA reinforces safety information about serious low blood sugar levels and mental health side effects with fluoroquinolone antibiotics; requires label changes. Available at: https://www.fda.gov/drugs/drug-safety-and-availability/fda-reinforces-safety-information-about-serious-low-blood-sugar-levels-and-mental-health-side. Accessed April 29, 2019.
  5. 5.
    Kabbani S, Hersh AL, Shapiro DJ, Fleming-Dutra KE, Pavia AT, Hicks LA. Opportunities to improve fluoroquinolone prescribing in the United States for adult ambulatory care visits. Clin Infect Dis 2018; 67(1):134–136.CrossRefGoogle Scholar
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    Shively NR, Buehrle DJ, Clancy CJ, Decker BK. Prevalence of inappropriate antibiotic prescribing in primary care clinics within a Veterans Affairs Health Care System. Antimicrob Agents Chemother 2018;62(8):e00337–18.CrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • Adrian Brown
    • 1
  • Jordan R. Wong
    • 1
  • Sheetal Kandiah
    • 2
  • Justin Moore
    • 3
  • Kristi Quairoli
    • 1
    Email author
  1. 1.Department of Pharmacy and Drug InformationGrady Health SystemAtlantaUSA
  2. 2.Division of Infectious DiseaseEmory University School of MedicineAtlantaUSA
  3. 3.College of PharmacyUniversity of GeorgiaAthensUSA

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