Reducing Fluoroquinolone Use Is a Key Step in Controlling the Burden of Clostridium difficile Infection

Walker, Ted; Ciorba, Matthew A.; Dubberke, Erik R.

doi:10.1053/j.gastro.2017.06.048

Gastroenterology

2017

DOI: 10.1053/j.gastro.2017.06.048

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Reducing Fluoroquinolone Use Is a Key Step in Controlling the Burden of Clostridium difficile Infection

Ted Walker

Matthew A. Ciorba

Erik R. Dubberke

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“…[3][4][5] Increasing evidence has called into question the safety of fluoroquinolone prescriptions in clinical practice. [6][7][8][9] Prolonged therapy has been linked to the development of antimicrobial-resistant bacteria as well as Clostridioides difficile infection [10][11][12][13][14][15] . Furthermore, serious toxicities associated with this drug class include peripheral neuropathy, tendon injury, cardiac arrhythmias, and aortic pathology.…”

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Outpatient fluoroquinolone prescribing patterns before and after US FDA boxed warning

Bratsman

Mathias

Laubscher

et al. 2020

Pharmacoepidemiology and Drug

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Objectives Fluoroquinolones are routinely overprescribed for uncomplicated urinary tract infection (uUTI), acute sinusitis, and acute bronchitis. In 2016, the United States (US) Food and Drug Administration (FDA) updated the boxed warning on fluoroquinolones, recommending against their use as first‐line agents for the routine pharmacologic management of uUTI, acute sinusitis, and acute bronchitis in patients who have other treatment options. The primary objective of this study was to determine if the 2016 expanded boxed warning was associated with decreased fluoroquinolone prescription rates for these three diagnoses. Methods We retrospectively reviewed antibiotics prescribed at a single, large, academic outpatient center for these three diagnoses between January 2013 and May 2018. Interrupted time series analysis was used to compare the rate of fluoroquinolone prescriptions before and after the May 2016 FDA boxed warning. Results A total of 10 087 antibiotic prescriptions for these three diagnoses were examined. There was no significant change in fluoroquinolone prescription rates after the FDA boxed warning. The majority of inappropriate fluoroquinolone prescriptions were given for the management of uUTI. Conclusion The 2016 US FDA boxed warning against fluoroquinolone use for uUTI, acute sinusitis, and acute bronchitis was not associated with a statistically significant reduction in the rate of fluoroquinolone prescriptions for these diagnoses. Additional research is needed to define how US FDA boxed warnings may be incorporated into broader antibiotic stewardship programs to decrease overuse of fluoroquinolones and avoid adverse effects of the drug class, including Clostridioides difficile infections and emergence of resistant organisms.

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mentioning

confidence: 99%

Outpatient fluoroquinolone prescribing patterns before and after US FDA boxed warning

Bratsman

Mathias

Laubscher

et al. 2020

Pharmacoepidemiology and Drug

View full text Add to dashboard Cite

show abstract

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Reducing Fluoroquinolone Use Is a Key Step in Controlling the Burden of Clostridium difficile Infection

Cited by 1 publication

References 0 publications

Outpatient fluoroquinolone prescribing patterns before and after US FDA boxed warning

Outpatient fluoroquinolone prescribing patterns before and after US FDA boxed warning

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