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Evaluation of the appropriate use of commonly prescribed fluoroquinolones and the risk of dysglycemia.
Ther Clin Risk Manag. 2015; 11:639-47.TC

Abstract

BACKGROUND

Fluoroquinolones are among the most widely prescribed antibiotics. However, concerns about increasing resistant microorganisms and the risk of dysglycemia associated with the use of these agents have emerged.

OBJECTIVE

The primary objective of the study was to evaluate the appropriate use of commonly prescribed fluoroquinolones, including appropriate indication, dose, dose adjustment in renal impairment, and duration of treatment. The secondary objective was to investigate the dysglycemic effect of fluoroquinolone use (hypoglycemia and/or hyperglycemia) in diabetic and nondiabetic patients.

METHODS

A prospective observational study at a teaching hospital in Lebanon was conducted over a 6-month period. A total of 118 patients receiving broad-spectrum fluoroquinolones (levofloxacin, ciprofloxacin, and moxifloxacin) were identified. Patients were mainly recruited from internal medicine floors and intensive care units.

RESULTS

The final percentage for the appropriate indication, dose, and duration of fluoroquinolone therapy was 93.2%, 74.6%, and 57.6%, respectively. A total of 57.1% of the patients did not receive the appropriate dose adjustment according to their level of renal impairment. In addition, dysglycemia occurred in both diabetic and nondiabetic patients. Dysglycemia was more frequently encountered with ciprofloxacin (50.0%), followed by levofloxacin (42.4%) and moxifloxacin (7.6%). Hyperglycemia was more common than hypoglycemia in all groups. The highest incidence of hyperglycemia occurred with levofloxacin (70.0%), followed by ciprofloxacin (39.0%) and moxifloxacin (33.3%). In contrast, hypoglycemia did not occur in the ciprofloxacin group, but it was more common with moxifloxacin (11.1%) and levofloxacin (6.0%).

CONCLUSION

The major clinical interventions for the future will adjust the dose and duration of therapy with commonly prescribed fluoroquinolones. The incidence of hypoglycemia was less common than hyperglycemia.

Authors+Show Affiliations

Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, Byblos, Lebanon.Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, Byblos, Lebanon.Children's National Medical Center, Washington, DC, USA.Medex Pharmaceutical Company, Beirut, Lebanon.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25960658

Citation

Kabbara, Wissam K., et al. "Evaluation of the Appropriate Use of Commonly Prescribed Fluoroquinolones and the Risk of Dysglycemia." Therapeutics and Clinical Risk Management, vol. 11, 2015, pp. 639-47.
Kabbara WK, Ramadan WH, Rahbany P, et al. Evaluation of the appropriate use of commonly prescribed fluoroquinolones and the risk of dysglycemia. Therapeutics and clinical risk management. 2015;11:639-47.
Kabbara, W. K., Ramadan, W. H., Rahbany, P., & Al-Natour, S. (2015). Evaluation of the appropriate use of commonly prescribed fluoroquinolones and the risk of dysglycemia. Therapeutics and Clinical Risk Management, 11, 639-47. https://doi.org/10.2147/TCRM.S81280
Kabbara WK, et al. Evaluation of the Appropriate Use of Commonly Prescribed Fluoroquinolones and the Risk of Dysglycemia. Therapeutics and clinical risk management. 2015;11:639-47. PubMed PMID: 25960658.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of the appropriate use of commonly prescribed fluoroquinolones and the risk of dysglycemia. AU - Kabbara,Wissam K, AU - Ramadan,Wijdan H, AU - Rahbany,Peggy, AU - Al-Natour,Souhaila, Y1 - 2015/04/22/ PY - 2015/5/12/entrez PY - 2015/5/12/pubmed PY - 2015/5/12/medline KW - ciprofloxacin KW - dysglycemia KW - fluoroquinolones KW - levofloxacin KW - moxifloxacin SP - 639 EP - 47 JF - Therapeutics and clinical risk management VL - 11 N2 - BACKGROUND: Fluoroquinolones are among the most widely prescribed antibiotics. However, concerns about increasing resistant microorganisms and the risk of dysglycemia associated with the use of these agents have emerged. OBJECTIVE: The primary objective of the study was to evaluate the appropriate use of commonly prescribed fluoroquinolones, including appropriate indication, dose, dose adjustment in renal impairment, and duration of treatment. The secondary objective was to investigate the dysglycemic effect of fluoroquinolone use (hypoglycemia and/or hyperglycemia) in diabetic and nondiabetic patients. METHODS: A prospective observational study at a teaching hospital in Lebanon was conducted over a 6-month period. A total of 118 patients receiving broad-spectrum fluoroquinolones (levofloxacin, ciprofloxacin, and moxifloxacin) were identified. Patients were mainly recruited from internal medicine floors and intensive care units. RESULTS: The final percentage for the appropriate indication, dose, and duration of fluoroquinolone therapy was 93.2%, 74.6%, and 57.6%, respectively. A total of 57.1% of the patients did not receive the appropriate dose adjustment according to their level of renal impairment. In addition, dysglycemia occurred in both diabetic and nondiabetic patients. Dysglycemia was more frequently encountered with ciprofloxacin (50.0%), followed by levofloxacin (42.4%) and moxifloxacin (7.6%). Hyperglycemia was more common than hypoglycemia in all groups. The highest incidence of hyperglycemia occurred with levofloxacin (70.0%), followed by ciprofloxacin (39.0%) and moxifloxacin (33.3%). In contrast, hypoglycemia did not occur in the ciprofloxacin group, but it was more common with moxifloxacin (11.1%) and levofloxacin (6.0%). CONCLUSION: The major clinical interventions for the future will adjust the dose and duration of therapy with commonly prescribed fluoroquinolones. The incidence of hypoglycemia was less common than hyperglycemia. SN - 1176-6336 UR - https://www.unboundmedicine.com/medline/citation/25960658/Evaluation_of_the_appropriate_use_of_commonly_prescribed_fluoroquinolones_and_the_risk_of_dysglycemia_ L2 - https://dx.doi.org/10.2147/TCRM.S81280 DB - PRIME DP - Unbound Medicine ER -
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