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Evaluation of the appropriate use of commonly prescribed fluoroquinolones and the risk of?dysglycemia

机译:评估常用氟喹诺酮类药物的合理使用和血糖异常的风险

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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.
机译:背景:氟喹诺酮类药物是使用最广泛的抗生素之一。然而,已经出现了关于增加抗药性微生物和与使用这些药剂相关的血糖异常的风险的担忧。目的:该研究的主要目的是评估常用氟喹诺酮类药物的适当使用,包括适当的适应症,剂量,肾功能不全的剂量调整以及治疗的持续时间。次要目的是研究在糖尿病和非糖尿病患者中使用氟喹诺酮的降糖作用(低血糖和/或高血糖)。方法:在黎巴嫩的一家教学医院进行了为期6个月的前瞻性观察研究。总共确定了118名接受广谱氟喹诺酮类药物(左氧氟沙星,环丙沙星和莫西沙星)的患者。患者主要来自内科和重症监护室。结果:氟喹诺酮治疗的适当适应症,剂量和持续时间的最终百分比分别为93.2%,74.6%和57.6%。共有57.1%的患者未根据其肾功能不全的水平进行适当的剂量调整。此外,糖尿病患者和非糖尿病患者均发生血糖异常。环丙沙星(50.0%),左氧氟沙星(42.4%)和莫西沙星(7.6%)更常见于血糖升高。在所有组中,高血糖症比低血糖症更为常见。高血糖发生率最高的是左氧氟沙星(70.0%),其次是环丙沙星(39.0%)和莫西沙星(33.3%)。相反,环丙沙星组未发生低血糖症,但莫西沙星(11.1%)和左氧氟沙星(6.0%)更为常见。结论:未来的主要临床干预措施将调整常用氟喹诺酮类药物的剂量和疗程。低血糖的发生率不如高血糖症常见。

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