Developing drug use evaluation criteria for parenteral fluoroquinolones

Area of Science:

• Pharmaceutical Care
• Antimicrobial Stewardship
• Drug Use Evaluation

Background:

• Optimal pharmacotherapy requires identifying, resolving, and preventing drug-related problems.
• Drug Use Evaluation (DUE) is a key tool for achieving optimal pharmacotherapy.
• Fluoroquinolone antimicrobials are frequently used, costly, and associated with high-risk populations, making them suitable for DUE.

Purpose of the Study:

• To establish evidence-based Drug Use Evaluation (DUE) criteria for parenteral fluoroquinolones.
• To guide the appropriate and cost-effective use of intravenous fluoroquinolones.
• To address the lack of published DUE criteria for parenteral fluoroquinolones.

Main Methods:

• Review of Joint Commission criteria for targeting drugs for DUE.
• Analysis of fluoroquinolone characteristics (cost, risk, usage patterns).
• Development of suggested DUE criteria for parenteral fluoroquinolone use.

Main Results:

• Fluoroquinolones meet criteria for DUE due to high-risk populations, cost, potential for inappropriate use, and frequent prescription.
• Suggested DUE criteria include specific patient populations (e.g., GI malabsorption), severe infections, aminoglycoside replacement, targeting resistant pathogens, and therapeutic use only.
• No prior published DUE criteria for parenteral fluoroquinolones were identified.

Conclusions:

• The DUE process is critical for ensuring safe, effective, appropriate, and economical drug therapy.
• Implementing DUE criteria for parenteral fluoroquinolones can enhance antimicrobial stewardship.
• DUE serves as an effective mechanism for evaluating new agents and educating clinicians post-marketing.