Fluoroquinolones: use of clinical data to aid formulary choice by the system of objective judgement analysis (SOJA)...

Fluoroquinolones are used in many hospitals for the treatment of complicated urinary tract infections, gastrointestinal infections, hospital acquired pneumonia and osteomyelitis. A review of the fluoroquinolones by the System of Objective Judgement Analysis (SOJA) method is presented. The following selection criteria were involved in the study: the number of registered indications, the number of dosage forms, the ratio between the area under the plasma concentration-time curve (AUC) and the minimum inhibitory concentration for 90% of strains (MIC 90), variability of the oral bioavailability, drug interactions, dosage frequency, equal dosage for oral and parenteral use, development of resistance, clinical efficacy, adverse events, cost and documentation. Both the oral and the parenteral formulation were included in the study. Ofloxacin shows the highest score, mostly because of the lower incidence of drug interactions, dosage frequency, cost and (relative to ciprofloxacin) a similar dosage for oral and parenteral use. Ciprofloxacin is the best documented drug. Pefloxacin shows the lowest SOJA score. Users of this method are free to determine the relative weight of the various selection criteria that they consider to be correct, although some of the criteria are internationally valid.