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Avoid fluoroquinolones as first-line antibiotic therapy

May 18, 2022
Increasing rates of resistance and adverse drug reactions should limit use.

The following message is from Alberta Health Services (AHS):

Due to increasing rates of resistance, risks of rare but serious disabling adverse effects, and significant association with Clostridioides difficile infection, the use of fluoroquinolones (FQ) should be limited or avoided as a first-line antimicrobial choice for common bacterial infections. FQ use should instead be focused on culture and susceptibility-confirmed infections, where the benefit of a FQ outweighs these risks.

To support this limited use, microbiology labs in Alberta will soon change the susceptibility reporting for urinary isolates of Escherichia coli, Proteus mirabilis, and Klebsiella spp. (excluding K. aerogenes):

  • If other agents also test as susceptible, ciprofloxacin will not be reported, and the following comment will be added: Ciprofloxacin is not routinely reported, given the potential for significant adverse events and increasing antimicrobial resistance.
  • If the urinary isolate is resistant to ciprofloxacin, this result will be reported.

For more information on the Antimicrobial Stewardship Program, visit the AHS website.