Antibiotic Stewardship Programme: Focusing on Ciprofloxacin

Abstract

Antibiotic resistance limits the choice of agents against microbes, and such phenomenon has been refl ected by the changes of recommendations in treatment guidelines. World Health Organization’s (WHO) Global Report on Surveillance of Antimicrobial Resistance issued an alert that resistance had occurred in even “last resort” antibiotics all over the world in 2014 and urged the preservation of our weapons against superbug. Ciprofl oxacin is one of the agents facing the resistance problem. Ciprofl oxacin is the only orally active agent with good effi cacy against Pseudomonas aeruginosa (P. aeruginosa), but resistance from this pathogen has been widely reported in surveillance studies. Implementing Antibiotic Stewardship Programme (ASP) and drug use evaluation (DUE) can optimize the use of ciprofl oxacin and other antibiotics and preserve their distinct property. Increase in susceptibility of P. aeruginosa to ciprofl oxacin as a result of ASP has been demonstrated in various studies previously. Other advantages of ASP include a reduction of antimicrobial use while not compromising patient outcome. In this review, previous ASP and DUE studies of ciprofl oxacin will be discussed with their pros and cons, followed by the framework for future local ASP development. The importance of education, surveillance, approval system, IT development and managerial involvement will also be highlighted.