Pros and cons of the use of fluoroquinolone antibiotics in patients with kidney disease
Abstract
Fluoroquinolones are among the most commonly prescribed antibiotics worldwide [1, 2]. In 2020, 4.7 million ciprofloxacin prescriptions and 1.8 million levofloxacin prescriptions were filled in the USA [3]. Between 2016 and 2020, Spain had the highest fluoroquinolone use rates in six European countries, ranging from 2.8 to 8.0 per 1000 persons per month, followed by Belgium, Germany, France and the Netherlands, with rates ranging from 2.0 to 5.7, 1.3 to 2.9, 1.3 to 2.5, and 1.5 to 2.0 per 1000 persons per month, respectively. In contrast, the UK had the lowest incidence rates, ranging from 0.7 to 1.2 per 1000 persons per month. Fluoroquinolones are highly bioavailable and have broad-spectrum antimicrobial activities [1, 2]. These antibiotics are used to treat common bacterial infections, such as urinary tract infections, pneumonia and intra-abdominal infections [1, 2]. In Europe, the most frequent fluoroquinolone indications reported between 2016 and 2020 were respiratory tract infections, urinary tract infections (uncomplicated) and ear infections [3]. The rate of fluoroquinolone resistance has dramatically increased worldwide. In 2021, it was reported that fluoroquinolone resistance in Escherichia coli isolates was high in several European countries. Specifically, 17 out of 45 countries had a resistance rate of 25% or higher. Spain had the highest rate at 27%, followed by Belgium at 19%, the UK at 16%, Germany at 15%, France at 15% and the Netherlands at 13%. The prevalence…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 4,140 participants or records.
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