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Cipro, related antibiotics over-prescribed, fueling microbe resistance

A new study heightens concerns that Cipro and related broad-spectrum antibiotics known as fluoroquinolones are being over-prescribed, accelerating bacterial resistance to the drugs and reducing their ability to treat infections.

The UCSF-led study evaluated the records of more than 13,000 patients across the country hospitalized for "community-acquired" pneumonia pneumonia that developed before the patient was hospitalized. The researchers found that fluoroquinolones were widely prescribed to patients discharged from the hospital, even when tests showed that narrow-spectrum antibiotics were appropriate.

"Overuse of fluoroquinolones for infections that can be treated with narrow-spectrum antibiotics has seriously eroded their effectiveness," said Joseph Guglielmo, PharmD, UCSF professor of clinical pharmacy and director of the antimicrobial review program at the UCSF Medical Center.

Fluoroquinolones have been particularly useful in treating common bladder infections and infections associated with cystic fibrosis. "But we've seen dramatic increases in bacterial resistance to these agents over the past few years," Guglielmo said.

He presented the new findings in a poster session at the annual meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) in San Diego.

The study found that 30 to 35 percent of patients with bacterial pneumonia due to penicillin-susceptible streptococcus were prescribed the broad-spectrum fluorquinolones upon discharge from the hospital. The American Thoracic Society recommends that the narrowest spectrum agent be chosen. Prescribing the broader-spectrum drug accelerates development of bacterial resistance to the antibiotics, Guglielmo said.

The E. coli bacterium is the most common cause of bladder infections, and Cipro and related fluoroquinolones are the most widely used and recommended antibiotic to treat these infections, Guglielmo said. As recently as 1997 the
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Contact: Wallace Ravven
wravven@pubaff.ucsf.edu
415-476-2557
University of California - San Francisco
28-Sep-2002


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