Infection Control Department, An-Najah National University Hospital, Nablus, 44839, Palestine.
Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
BMC Infect Dis. 2024 Aug 23;24(1):856. doi: 10.1186/s12879-024-09749-4.
Fluoroquinolones are the most commonly prescribed antibiotics. Because of their known tendency to drive antimicrobial resistance, their prescribing patterns need to be more restricted. This study aimed to describe the clinical practice of fluoroquinolone prescription, dose adjustments for renal impairment patients and bacterial resistance profiles, eventually providing evidence-based recommendations to optimize antibiotic prescribing practices in the local population.
This retrospective, cross-sectional study was conducted at An-Najah National University Hospital in Palestine. The data were collected from admitted patients who were given ciprofloxacin or levofloxacin from July 2021 to June 2023. Data from 692 inpatients across various hospital departments were examined (409 for levofloxacin and 283 for ciprofloxacin). Statistical analysis was performed via IBM SPSS version 23.0 to summarize the demographic, clinical, and epidemiological data.
The sociodemographic profile revealed diverse age distributions, with 25.4% and 39% older than 50 years for ciprofloxacin and levofloxacin, respectively. Ciprofloxacin was predominantly used in the oncology department (28.2%), with surgical prophylaxis (22.6%) and febrile or afebrile neutropenia (21.1%) being the most common indications. Levofloxacin was predominantly used in the medical ward (45.7%), mainly for lower respiratory tract infection (58.8%) and prophylaxis for bone marrow transplantation (16.5%). Enterococcus and methicillin-resistant Staphylococcus aureus were the most commonly isolated pathogens, with 62.5% of the isolates demonstrating resistance to ciprofloxacin. Moreover, extended-spectrum beta-lactamase-producing Enterobacterales were the most common pathogen isolated, with 33.3% being resistant to levofloxacin. Statistical analysis revealed a significant association between the choice of antibiotic and the approach to therapy. Levofloxacin was significantly more likely than ciprofloxacin to be used as empiric therapy (p < 0.001), whereas ciprofloxacin was more likely to be used as targeted therapy (p < 0.001).
This study investigated prescribing practices and resistance to levofloxacin and ciprofloxacin in a large hospital in a developing country. According to the bacterial resistance profiles, we conclude that there is a need for hospital departments to exercise greater restraint on the use of these antibiotics. To this end, further studies addressing the clinical efficacy of fluoroquinolones against the current treatment guidelines to evaluate their appropriateness should be carried out.
氟喹诺酮类药物是最常被开的抗生素。由于它们具有已知的推动抗菌药物耐药性的倾向，因此需要对其处方模式进行更严格的限制。本研究旨在描述氟喹诺酮类药物的处方临床实践、肾功能损害患者的剂量调整以及细菌耐药谱，最终为优化当地人群的抗生素处方实践提供循证建议。
这是一项在巴勒斯坦纳贾赫国立大学医院进行的回顾性、横断面研究。数据来自 2021 年 7 月至 2023 年 6 月期间接受环丙沙星或左氧氟沙星治疗的住院患者。共检查了 692 名来自不同医院科室的住院患者的数据（左氧氟沙星 409 例，环丙沙星 283 例）。使用 IBM SPSS 版本 23.0 进行统计分析，以总结人口统计学、临床和流行病学数据。
社会人口统计学特征显示出不同的年龄分布，环丙沙星和左氧氟沙星的年龄分别有 25.4%和 39%大于 50 岁。环丙沙星主要用于肿瘤科（28.2%），最常见的适应症是手术预防（22.6%）和发热或不发热性中性粒细胞减少症（21.1%）。左氧氟沙星主要用于内科病房（45.7%），主要用于下呼吸道感染（58.8%）和骨髓移植预防（16.5%）。肠球菌和耐甲氧西林金黄色葡萄球菌是最常见的分离病原体，62.5%的分离物对环丙沙星耐药。此外，产超广谱β-内酰胺酶的肠杆菌科是最常见的分离病原体，33.3%对左氧氟沙星耐药。统计分析显示，抗生素的选择与治疗方法之间存在显著关联。左氧氟沙星比环丙沙星更有可能被用作经验性治疗（p<0.001），而环丙沙星更有可能被用作靶向治疗（p<0.001）。
本研究调查了在一个发展中国家的大型医院中左氧氟沙星和环丙沙星的处方实践和耐药情况。根据细菌耐药谱，我们得出结论，医院科室需要对这些抗生素的使用更加谨慎。为此，应进一步开展针对氟喹诺酮类药物针对当前治疗指南的临床疗效的研究，以评估其适宜性。
