Evaluation Doctors often prescribe high-risk antibiotics

Fluoroquinolones are often prescribed for minor diseases
In Germany, doctors often prescribe important antibiotics from the fluoroquinolone group, even if they are not absolutely necessary. This has resulted in a recent analysis by the Scientific Institute of the AOK (WIdO). The drugs involved can have massive side effects and are actually designed to treat serious and life-threatening infections. But according to the WidO, they are often used even in minor diseases.

Active ingredients are said to help with life-threatening infections
Antibiotics from the group of fluoroquinolones are used more frequently in this country than it should be. This emerges from a communication from the institute of the AOK (WidO). After all, the active ingredients in question are actually intended for the treatment of the most serious, life-threatening illnesses and can have serious health consequences.

According to a recent analysis by the Scientific Institute of the AOK, physicians often prescribe important reserve antibiotics. (Image: Henrik Dolle / fotolia.com)

Because of serious side effects, antibiotic drugs from this group have undergone a new risk assessment by the European Medicines Agency (EMA) since early 2017. According to the WidO, only five different drugs or groups of drugs are currently under review by the EMA - a relatively small number with regard to the approximately 2,500 active substances and drug combinations currently used, the report said.

Thorough benefit-risk assessment necessary
"Given the possible serious and long-lasting side effects such as tendon tears, mental disorders such as depression and anxiety, these reserve antibiotics should be used only after thorough benefit-risk consideration by the doctor," said Helmut Schröder, Deputy Managing Director of the Scientific Institute of the AOK (WIdO).

But that seems to be rare in daily practice. For the analysis of the institute showed that the active substances concerned in 2015 with 5.9 million prescribed drug packages even represented the fourth most prescribed antibiotics group. Thus, 16.4 percent of the approximately 38 million antibiotic prescriptions were fluoroquinolones.

An extrapolation of the WIdO on the basis of the AOK insured persons showed that more than four million legally insured persons received these antibiotics. In most cases (just under 63%), the active substance ciprofloxacin was prescribed, 70% of the prescriptions were issued by general practitioners.

Awareness needs on both sides
This suggests that the drugs are used not only in life-threatening diseases but also in minor diseases such as uncomplicated urinary tract infection (e.g., bladder infection), bronchitis, or sinusitis. In order to avoid resistance to fluoroquinolones and side effects, it makes sense, however, to use the drugs only with restraint, so the WidO.

In many cases, older, tried and tested remedies should be used instead. But there is still a need for information - both from the patients and the doctors. Patients should be aware that antibiotics that end in "floxacin" may have side effects and that there are well-effective alternatives.

Use antibiotic as rarely as possible
"As rare and as targeted as possible" - this "golden rule" should therefore always apply when it comes to the administration of antibiotics. Because "this is the only way to ensure that the future treatment options of an antibiotic are not frivolously put at risk and at the same time the patients are not exposed to unnecessary dangers", explained Schröder. (No)