Drug Utilization Evaluation of Levofloxacin at a Secondary Care Center in Hyderabad, India

Drug use evaluation is an ongoing, systematic, criteria-based program of medicine evaluations that will help ensure appropriate medicine use. If therapy is determined to be inappropriate, interventions with providers or patients will be necessary to optimize pharmaceutical therapy. A DUE can be structured so that it will assess the actual process of administering or dispensing a medicine (i.e., appropriate indications, dose, and medicine interactions) or assess the outcomes. Empirical therapy forms the basis of treatment in India mostly and it is the responsibility of DTC (Drugs and therapeutics committee) to organize a DUE study and adopt suitable protocol for controlling irrational drug use. In our study we have developed a data collection form based upon WHO guidelines for conducting a DUE study on Levofloxacin use evaluation. Ours is a retrospective study conducted from the dates corresponding to 1-8-2015 to 31-7-2016. A total of 62 case records were obtained containing Levofloxacin as one of the drug in the prescription. The gender distribution of case sheets were male- 24, female- 38. Indication wise the distribution of case sheets were - Lower respiratory tract infections = 26, Pulmonary Kochs = 06, Cystitis = 02, Non indicated = 18, Upper respiratory tract infection = 04, Urinary tract infection = 06. The minimum dose administered was 35 mg/day and the maximum dose administered per day was 2000 mg/day. The minimum number of days of treatment was 1 day and the maximum number of days of treatment was 38 days. All patient folders evaluated with regards to UTI, CAP, KOCHS were found to meet the standard criteria appropriate for Levofloxacin use with respect to dose, and dose frequency. However, in the case of dose duration the evaluation was found to be largely inappropriate for all the justified indications. In addition, twenty nine percentage of Levofloxacin use for unjustified indications was noted. This means that Levofloxacin has been deviated from standard treatment guidelines hence it facilitates the development of resistant strains to Levofloxacin and of no use in the near future, and it also effect the patient economically.