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Abstract
Introduction
Fluoroquinolones (FQs) is a distinct class of antibiotics which are prescribed and used quite frequently worldwide, despite the box warnings (BW) issued by Food and Drug Administration (FDA). Literature has shown in spite of BWs related to FQs there is minimal impact on health care professionals (HCPs) prescribing habits, potentially attributing towards limited and insufficient awareness. In Pakistan, FQs are mostly prescribed antibiotics for microbial treatments, therefore the purpose of this study was to determine the level of knowledge about the safety profile, use, and BW of FQs among HCPs working in Pakistan.
Methods
A cross-sectional study was undertaken among the HCPs of Khyber Pakhtunkhwa province of Pakistan from October 2022 to December 2022. A validated questionnaire was used to assess the knowledge of HCPs regarding FQs, its safety profile and BW. A random convenient sample technique was used while recruiting HCPs in this study. As the HCPs comprised physicians, dentists, pharmacist and nurses, all were approached in person and the study objective was fully elaborated and explained to them. The statistic test like: one-way ANOVA, independent-t test, multivariate logistic regression were used keeping the p-value < 0.05 as statistically significant.
Results
A total of n = 250 HCPs were approached, of which n = 186 HCPs completed the questionnaire with a response rate of 74.4%. FQs prescribing pattern was only assessed among the prescribers, i.e., physicians and dentists (39/186). The mean knowledge score for indications was 5.29 ± 3.05, while for the adverse effects was 7.70 ± 2.61. The highest score for knowledge for indications and adverse effect score was achieved by physicians followed by dentist. The mean knowledge score for the BW was 3.46 ± 2.93 and among the HCPs for the BW of FQs, 20.4% of the HCPs had appropriate knowledge score (score ≥ 50%). The knowledge score was significantly higher in males (p = 0.039), dentists (p = 0.001), HCPs having master/specialization level of education (p = 0.003), HCPs working in government sector hospitals (p = 0.010) and secondary care hospitals (p = 0.001) while the multivariate logistic regression analysis showed that HCPs working in primary care hospital (OR: 6.2) and secondary care hospital (OR: 20.3) were associated with the tendency to achieve 50% or above knowledge score.
Conclusion
Findings of this study reveals the unsatisfactory knowledge of HCPs regarding the safety profile, use, and BW of FQs putting patients at heightened risks of FQs associated AEs. Therefore, it is crucial to implement a national antimicrobial stewardship program, seminars and lectures aimed at continuously updating the knowledge of HCPs, regardless of their specialties, and effectively restrict the misuse of antimicrobial and disseminate FDA BWs in clinical practice.
Muhammad Abbas and Kashif Kashmiri have contributed equally and share the 1st authorship position.
Muhammad Abbas and Kashif Kashmiri have contributed equally and share the 1st authorship position.
Acknowledgements
The authors would like to thank the Deanship of Scientific Research at Shaqra University for supporting this work.
Author contributions
Conceptualization: MA, KK, IUR; data curation: MA, KK, IUR; formal analysis: IUR, ZA, TMK; investigation: IUR, LCM, ZA, TMK; methodology: IUR, ZA, AZ, LCM, TMK and MS; project administration: IUR, MS; supervision: IUR; writing—original draft: MA, KK, AK; writing—review and editing: IUR, AZ, LCM, TMK, MS. All authors approved the submission of the final manuscript.
Funding
None.
Availability of data and materials
The datasets are available from the corresponding author upon reasonable request.
Declarations
Ethics approval and consent to participate
The ethics committee of Abdul Wali Khan University Mardan granted approval via letter no: EC/AWKUM/2022/24/479 (dated 26/06/2022). As part of the ethics approval process, informed written consent was obtained from the HCPs.
Consent for publication
Not applicable.
Competing interests
The authors declare that they have no competing interests.
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