Local Fluoroquinolone Resistance in Taber, Alberta Area
There is no specific data available on fluoroquinolone resistance patterns specifically for the Taber, Alberta area in the provided evidence.
General Considerations for Fluoroquinolone Resistance
- Fluoroquinolone resistance varies considerably between geographic regions and countries, making specific local resistance data essential for guiding empirical antimicrobial therapy 1
- Resistance rates to fluoroquinolones have shown a clear increasing trend in many regions compared to previous years 1
- In some countries and regions, fluoroquinolone resistance rates exceed 10-20% for common pathogens 1
Factors Affecting Fluoroquinolone Resistance
- Previous use of fluoroquinolones in the preceding 3-6 months is an independent risk factor for developing resistance 1
- Travel outside the country in the preceding 3-6 months is independently associated with increased resistance 1
- Individual risk factors for fluoroquinolone resistance include recent fluoroquinolone use, hospitalization, advanced age, and recent ocular surgery 1
- Multiple fluoroquinolone prescriptions are more strongly associated with resistance development than single prescriptions 2
Resistance Patterns in North America
- Resistance rates for fluoroquinolones were generally higher in US medical centers than in Canadian medical centers 1
- In most parts of North America, fluoroquinolone resistance rates were still <10% according to older surveillance data, but with increasing trends 1
- A study of over 3,200 ocular isolates found methicillin resistance in 42% of Staphylococcal isolates, with high concurrent resistance to fluoroquinolones 1
Recommendations for Clinical Practice Without Local Data
- When local resistance data is unavailable, consider nitrofurantoin, fosfomycin, or mecillinam for empirical therapy of urinary tract infections as these antimicrobials maintained good activity across regions 1
- For severe infections requiring hospitalization, an intravenous antimicrobial regimen should be chosen based on local resistance data when available 1
- In the absence of specific local resistance data for the Taber, Alberta area, clinicians should consult with regional microbiology laboratories or infectious disease specialists to obtain the most current resistance patterns before prescribing fluoroquinolones empirically 1
Implications for Antimicrobial Stewardship
- Fluoroquinolones should not be prescribed when other effective antibiotics could be used 1
- Fluoroquinolones should not be prescribed repeatedly in the same patient (consider prescriptions within the last 6 months) 1
- Fluoroquinolones should not be prescribed as empirical monotherapy in severe nosocomial infections 1
- Fluoroquinolones should be reserved for specific indications where they are truly necessary to preserve their effectiveness 3
Pitfalls and Caveats
- Hospital antibiograms may not accurately reflect community-acquired resistance patterns 4
- Resistance to one fluoroquinolone often indicates class resistance to other fluoroquinolones 1
- Increasing use of fluoroquinolones in all age groups is resulting in a corresponding increase in bacterial resistance 1
- The absence of specific local data should prompt more cautious use of fluoroquinolones rather than empiric prescribing 3