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Year : 2021  |  Volume : 26  |  Issue : 1  |  Page : 14-18

Fluoroquinolone use in a rural practice

1 Sioux Lookout Meno Ya Win Health Centre, Sioux Lookout, Canada
2 Sioux Lookout Meno Ya Win Health Centre; Northern Ontario School of Medicine, Sioux Lookout, Canada
3 Sioux Lookout First Nations Health Authority, Sioux Lookout, Canada
4 Assembly of First Nations, Akwwsasne, Canada
5 Sioux Lookout NOSM Local Education group, Sioux Lookout, Canada
6 Hugh Allen Clinic, Sioux Lookout, Canada
7 Northern Ontario School of Medicine, Sioux Lookout, Canada

Correspondence Address:
MD, M Clin Sci, FCFP, FRRM Len Kelly
Sioux Lookout Meno Ya Win Health Centre, Sioux Lookout
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/cjrm.cjrm_67_20

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Introduction: Fluoroquinolones (FQs) are a commonly prescribed class of antibiotics in Canada. Evidence of a constellation of possible adverse events is developing. Central and peripheral nervous system abnormalities and collagen-related events (including aortic aneurysm/dissection, tendinopathy/rupture and retinal detachment) are associated with FQ exposure in large population-based aftermarket studies. In 2017, Health Canada warned about rare FQ-related persistent or disabling side effects. This study explores FQ use in a rural community. Methods: Antibiotic prescriptions (including FQs) in the over 18 adult population (5416) were measured in the town of Sioux Lookout for 5 years, January 2013 to 31 December 2017. Results: FQ prescriptions accounted for 16.0% of adult antibiotics, superseded by penicillins (21.1%) and macrolides (18.2%). Ciprofloxacin accounted for one half of FQ use (51.2%), followed by levofloxacin (36.7%) and norfloxacin (13.3%). FQs were commonly used for respiratory (33%) and urinary tract infections (18%). Conclusion: Aftermarket evidence reports increased risk of 'disabling and persistent serious adverse events'(Health Canada) in patients using FQs. Appropriate clinical caution should be exercised in the prescribing of FQs. Common overuse seems to occur in the treatment of uncomplicated community-acquired pneumonia and cystitis, despite recommendations to use other antimicrobial agents as first-line treatments.

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