Evaluation of levofloxacin utilization in intensive care units of tertiary care hospital: a retrospective observational study

Background The emergence of antibiotic-resistant bacteria is a major problem throughout the world, and rational use of antibiotics is, therefore, very important. Levofloxacin is one of the most commonly used antibiotics due to its wide spectrum antimicrobial activity and low potential for toxicity. Drug use evaluation (DUE) focuses on evaluation and improvement of drug prescribing patterns to achieve optimal patient outcomes. Aim The study was designed to evaluate levofloxacin prescribing patterns, including appropriate indication, dose, dose adjustment in renal impairment, and duration of treatment, by conducting a DUE program in intensive care units (ICUs). Methods A retrospective observational study was conducted over a 4-month period. A total of 222 patients receiving levofloxacin (a broad-spectrum fluoroquinolone) were identified. Patients were primarily recruited from ICUs. Results The present study showed that levofloxacin was used empirically in most patients (78.4%). The most common indication for levofloxacin use was community-acquired pneumonia, observed in 75 patients (33.8%). Most commonly, the daily dose of levofloxacin was 500 mg or 750 mg, the frequency of administration was twice (27%) or once daily (73.0%), and the duration of treatment with levofloxacin was 7-10 days (67.6%). Inappropriate use of levofloxacin was observed in some patients (27.9%), the greatest proportion of which was attributed to absence of culture and sensitivity test (61.3%), followed by inappropriate indications (46.8%). Conclusions Our study indicated that there is substantial scope for improvement in prescribing patterns at Damanhour Medical National Institute that could be achieved by adhering to standard guidelines of treatment and restriction policies to promote rationality of drug use.