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Evaluation: Doctors prescribe high-risk antibiotics far too often


Fluoroquinolones are often prescribed for minor illnesses
In Germany, doctors often prescribe important antibiotic drugs from the fluoroquinolone group even when they are not absolutely necessary. This is the result of a current analysis by the AOK Scientific Institute (WIdO). The affected drugs can have massive side effects and are actually intended to treat serious and life-threatening infections. But according to the WidO, they are often also used for minor illnesses.

Active ingredients are said to help with life-threatening infections
Antibiotics from the group of fluoroquinolones are used more frequently in this country than they should be. This emerges from a message from the institute of the AOK (WidO). Because the active ingredients concerned are actually intended to cure the most serious, life-threatening diseases and can have serious health consequences.

Due to serious side effects, antibiotic medications from this group have been undergoing a new risk assessment by the European Medicines Agency since the beginning of 2017. According to the WidO, only five different medicinal products or groups of medicinal products are currently being checked by the EMA - a comparatively small number with regard to the approximately 2,500 active substances and combinations of active substances that are currently used, the message continues.

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

But that seems to be rare in everyday practice. Because the analysis of the institute showed that the active substances concerned represented the fourth most frequently prescribed antibiotic group in 2015 with 5.9 million prescribed pharmaceutical packs. This means that 16.4 percent of the roughly 38 million antibiotic prescriptions are fluoroquinolones.

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

Clarification needs on both sides
This suggests that the drugs are not only used for life-threatening diseases, but also for minor diseases such as an uncomplicated urinary tract infection (e.g. cystitis), bronchitis or sinus infection. To avoid resistance to fluoroquinolones and side effects, however, it makes sense to use the active ingredients only with caution, according to the WidO.

In many cases, older funds that have been tried and tested over many years should be used instead. But there is still a need for clarification - both on the part of the patients and the doctors. Patients should know that antibiotics that end with "floxacin" can have corresponding side effects and that there are well-effective alternatives.

Use the antibiotic as rarely as possible
"As rarely as necessary and as specifically 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 therapeutic opportunities of an antibiotic are not carelessly jeopardized and at the same time that the patient is not exposed to unnecessary dangers," said Schröder. (No)

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