DRUG UTILIZATION REVIEW OF FLUOROQUINOLONES ANTIBIOTICS BY USING PRESCRIBING INDICATORS & COMPARISON OF DEFINE DAILY DOSE & PRESCRIBED DAILY DOSE IN OUTPATIENTS

Background: The increase in antibiotic resistance is new developing threat to healthcare system. Irrational drug use, polypharmacy and the current epidemic of bacterial resistance is attributed to the increase in use of antibiotics. The aim of the current study is to evaluate the difference between defined daily dose and prescribed daily dose of fluoroquinolones antibiotics. Methodology: Quantitative observational, retrospective study was carried out to measure the use of antibiotics, specifically Fluoroquinolones at northern region of Punjab, Nowshera Virkan, Tehsil of Gujranwala District, Pakistan. Total 300 patients were enrolled in this study. Data were collected from the patients of all age from either sex, by prescription review. Data included the drug name, strength and quantity. Results: 300 prescriptions were reviewed to evaluate the prescription pattern of fluoroquinolones in outpatients. Among the prescribing indicators, the average number of drugs per prescription was 4.5. Out of 300 prescriptions maximum number of drugs per prescription was 8 in only one prescription and minimum one drug was prescribed in 28(9.3) prescriptions. The number of prescriptions that contains the drugs without generic were 71(23.7) and which contains one drug with generic were 203(67.7). Encounter with antibiotic prescribed were 79.3%. Encounter with injection prescribed was 5.3%. All drugs were prescribed from Essential drug list (EDL). Ciprofloxacin was the most commonly prescribed followed by Levofloxacin and Moxifloxacin. Defined daily dose and prescribed daily dose of Ciprofloxacin were same (1) but the prescribed daily dose of levofloxacin (0.5) was higher than the Defined Daily Dose (1). Conclusion: Irrational use of drugs, polypharmacy, over prescribing of antibiotics and brand prescribing were observed during the study. Lack of knowledge and nonadherence to the prescribing indicators are the major factors that contribute towards the irrational drug prescribing that ultimately lead towards the antibiotic resistance.