[The use of fluoroquinolone plasma levels by physicians].
OBJECTIVE
To assess how physicians use the results of fluoroquinolone plasma concentrations.


METHODS
A retrospective study was carried out on all the patients of the Infectiology department of the University Hospital in Nice who had undergone measurement of ofloxacin, ciprofloxacin or pefloxacin plasma levels between the 1st of January 2001 and the 31st of May 2002.


RESULTS
Seventy eight patients were included. Median duration of treatment was 90 days. In 43% of cases, the patients had also received an enzyme inducer (rifampin in 90% cases). The minimum inhibitory concentration was requested 12 times. In 26% of cases, a first inadequate concentration was not followed by a second control analysis. We noted that at the start of treatment, 56% of patients exhibited inadequate levels, and the dose of fluoroquinolone was hence increased by the physician in 40% of cases. We noted 4 bacteriological relapses, all within a context of insufficient dose, with selection of a resistant mutant three times.


CONCLUSIONS
Physicians do not appear to use the fluoroquinolone plasma levels to their best advantage.
Pulcini
C
C
Service d'infectiologie, Hôpital L'Archet 1, CHU de Nice. pulcini.c@chu-nice.fr
Bernard
E
E
Garraffo
R
R
Roger
P-M
PM
Tempesta
S
S
Dellamonica
P
P
D000890:Anti-Infective Agents / Q000097:blood*; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D024841:Fluoroquinolones / Q000097:blood*; D005602:France / Q000453:epidemiology; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy; D006801:Humans; D008875:Middle Aged; D009164:Mycobacterium Infections / Q000188:drug therapy; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy
D000890:Anti-Infective Agents; D004791:Enzyme Inhibitors; D024841:Fluoroquinolones