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Updated: Nov 23, 2025

Population and Single-Cell Analysis of Antibiotic Persistence in Escherichia coli
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Fluoroquinolone use in a rural practice.

Len Kelly1, Yoko S Schreiber2, Josh Hopko3

  • 1Sioux Lookout Meno Ya Win Health Centre, Sioux Lookout, Canada.

Canadian Journal of Rural Medicine : the Official Journal of the Society of Rural Physicians of Canada = Journal Canadien De La Medecine Rurale : Le Journal Officiel De La Societe De Medecine Rurale Du Canada
|December 31, 2020
PubMed
Summary

Fluoroquinolones (FQs) are frequently prescribed antibiotics, but carry risks of serious adverse events. This study highlights their common use and potential overuse in a rural Canadian community, urging clinical caution.

Keywords:
Antibioticfluoroquinolonerural

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Area of Science:

  • Pharmacology and Therapeutics
  • Infectious Diseases
  • Public Health

Background:

  • Fluoroquinolones (FQs) are widely prescribed antibiotics in Canada.
  • Growing evidence links FQ use to serious adverse events, including nervous system and collagen-related issues.
  • Health Canada issued a warning in 2017 regarding rare, persistent, or disabling FQ side effects.

Purpose of the Study:

  • To investigate the patterns of fluoroquinolone (FQ) utilization in a rural Canadian community.
  • To assess the frequency and indications for FQ prescribing in an adult population.

Main Methods:

  • A retrospective analysis of adult antibiotic prescriptions (n=5416) was conducted in Sioux Lookout from January 2013 to December 2017.
  • Prescription data included fluoroquinolones (FQs) and other antibiotic classes.

Main Results:

  • Fluoroquinolones (FQs) constituted 16.0% of adult antibiotic prescriptions.
  • Ciprofloxacin (51.2%) and levofloxacin (36.7%) were the most common FQs used.
  • FQs were frequently prescribed for respiratory (33%) and urinary tract infections (18%).

Conclusions:

  • Despite evidence of increased risk for disabling and persistent adverse events associated with FQs, their use remains common.
  • Overuse of FQs is noted for uncomplicated community-acquired pneumonia and cystitis, where first-line alternatives are recommended.
  • Clinical caution is advised when prescribing fluoroquinolones (FQs) due to potential serious side effects.