Indications for Systemic Fluoroquinolone Therapy in Europe and Prevalence of Primary-Care Prescribing in France, Germany and the UK: Descriptive Population-Based Study
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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.
Notes
Compliance with Ethical Standards
Funding
No sources of funding were used to conduct this study.
Conflict of interest
Daniel Morales has no conflicts of interest. Jim Slattery has no conflicts of interest. Luis Pinheiro has no conflicts of interest. Xavier Kurz has no conflicts of interest. Karin Hedenmalm has no conflicts of interest.
Ethical approval
Approval to conduct the studies using anonymized data was granted by the Scientific Review Committees of The Health Improvement Network (THIN) and IMS® (17THIN032).
Disclaimer
The views expressed in this article are the personal views of the author(s) and may not be not be understood or quoted as reflecting the views of the EMA or one of its committees or working parties.
Supplementary material
References
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