Indications for Systemic Fluoroquinolone Therapy in Europe and Prevalence of Primary-Care Prescribing in France, Germany and the UK: Descriptive Population-Based Study

Daniel R Morales (Lead / Corresponding author), Jim Slattery, Luis Pinheiro, Xavier Kurz, Karin Hedenmalm

Research output: Contribution to journalArticle

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Abstract

BACKGROUND AND OBJECTIVES: In the USA the benefit-risk profile of fluoroquinolones for treating patients with acute bacterial sinusitis, acute bacterial exacerbation of chronic bronchitis, and uncomplicated urinary tract infections (uUTIs) is considered unfavorable. However, the number of fluoroquinolone products in the EU indicated and prescribed for these infections is uncertain. The objective of this study was to provide data on indications for fluoroquinolones in Europe and examine the prevalence of prescribing in France, Germany and the UK.

METHODS: Descriptive analysis of indications for systemic fluoroquinolone antibiotics across the European Economic Area (EEA) and descriptive analysis of systemic fluoroquinolone antibiotic prescribing in France, Germany and UK electronic health records (2000-2015).

RESULTS: All EEA countries had fluoroquinolone products indicated for acute sinusitis, acute bronchitis, or uUTIs, with differences in the number of products between countries for: acute sinusitis (19.5-51.9%), acute bronchitis (22.2-73.4%), and uUTIs (52.0-89.1%). The prevalence of fluoroquinolone prescribing for the treatment of respiratory tract infections (RTIs) appeared to fall with time in all countries and for UTI in France and UK only. Changes were greatest in the UK. In France, Germany, and the UK, respectively: acute sinusitis accounted for 29.5, 20.6, and 40.7% of all oral fluoroquinolone prescriptions for upper RTIs; acute bronchitis accounted for 63.0, 83.0, and 89.9% of all fluoroquinolone prescriptions for lower RTIs; uUTIs accounted for 83.3, 89.9, and 32.2% of all fluoroquinolone prescriptions for UTIs.

CONCLUSION: Large numbers of fluoroquinolone products in Europe are listed for the treatment of milder infections such as acute bronchitis, acute sinusitis and uUTIs. Among the countries assessed, fluoroquinolones were commonly prescribed for these conditions and potentially should lead to a review of therapeutic guidelines.

Original languageEnglish
Pages (from-to)927-933
Number of pages7
JournalClinical Drug Investigation
Volume38
Issue number10
Early online date24 Aug 2018
DOIs
Publication statusPublished - Aug 2018

Keywords

  • Adult
  • Anti-Bacterial Agents/therapeutic use
  • Bronchitis/drug therapy
  • Drug Prescriptions
  • Europe/epidemiology
  • Female
  • Fluoroquinolones/therapeutic use
  • France/epidemiology
  • Germany/epidemiology
  • Humans
  • Male
  • Middle Aged
  • Population Surveillance/methods
  • Prevalence
  • Primary Health Care/trends
  • Respiratory Tract Infections/drug therapy
  • United Kingdom/epidemiology
  • Urinary Tract Infections/drug therapy

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