Norfloxacin and Ofloxacin
Norfloxacin use decreased by 86.8% over the study period (p < 0.001) (Table 1). Use of ofloxacin was limited, and no trends were evident (Table 1).
Gatifloxacin and moxifloxacin did not come onto the market until after the year 2000; as such, these drugs were not used at all in the early years of the study period, and their use was low after 2000. Therefore, these agents were combined with levofloxacin for evaluating the use of fluoroquinolones for community-acquired pneumonia over the entire study period. Together, these 3 medications are known as the “respiratory fluoroquinolones”. Use of these drugs increased significantly over the study period (p < 0.001) (Table 1). In 1997/1998, respiratory fluoroquinolones represented 0.65% of the combined total of respiratory fluoroquinolones and ciprofloxacin. This proportion increased to 67.4% in 2002/2003. In 2002/2003, the ratio of IV to oral use was 0.2. Variations in relative use existed among the DHAs, with districts A and I using more ciprofloxacin than respiratory fluoroquinolones (Figure 1). canada viagra online
Figure 2. Use of all respiratory fluoroquinolones combined (levofloxacin, moxifloxacin, and gatifloxacin) by fiscal year, relative to cases of community-acquired pneumonia in which patients were admitted to hospital (“CAP events”). Use increased significantly over the study period (p < 0.01) but levelled off in the last 2 years. DDD = defined daily dose.
Use of Respiratory Fluoroquinolones in Relation to Community-Acquired Pneumonia
The use of respiratory fluoroquinolones was also assessed with the WHO ATC/DDD methodology in relation to cases of community-acquired pneumonia in which the patients were admitted to hospital. Over the study period, mean use of respiratory fluoroquinolones increased from 3.4 to 1747.5 DDDs/100 cases of community-acquired pneumonia with hospital admission per year (Figure 2). From 1997/1998 to 2001/2002, mean use of levofloxacin increased from 3.4 to 1730.0 DDDs/100 cases of community-acquired pneumonia per year, but fell to 1593.8 DDDs/100 cases of community- acquired pneumonia per year in 2002/2003. Mean levofloxacin use varied among DHAs over the study period, ranging from 445.9 (DHA A) to 1506.5 (DHA H) DDDs/100 cases of community-acquired pneumonia with hospital admission per year. However, statistical tests of comparisons between DHA A and each of the other DHAs indicated no significant differences. Apcalis Oral Jelly