Survey on concurrent prescriptions for quinolones with non-steroidal anti-inflammatory drugs in 2 urban hospitals

Many package inserts state that concurrent therapy of quinolones with non-steroidal anti-inflammatory drugs (NSAIDs) is contraindicated, or careful patient monitoring is advised. However, the current status of concurrent therapy with these classes of agents has not been clarified. In this study, we surveyed the current status of concurrent therapy with these two classes of agents based on prescriptions in 2 urban hospitals, Mitsui Memorial Hospital and Sanraku Hospital. Between January 2002 and February 2002. 88, 159 outpatient clinic prescriptions (Mitsui Memorial Hospital: 51, 195 prescriptions, Sanraku Hospital: 36, 964 prescription) and 13, 692 inpatient prescriptions (Mitsui Memorial Hospital: 9, 543 prescriptions, Sanraku Hospital: 4, 149 prescriptions) were recorded. Quinolones were prescribed in 1.7% of the prescriptions in Mitsui Memorial Hospital in 0.8% of the prescriptions in Sanraku Hospital. The most common quinolone was levofloxacin (82.5% of all quinolone prescriptions), and it was followed by ciprofloxacin (8.9%). NSAIDs and/or antipyretic/analgesic drugs were prescribed in combination in 30.6% of quinolone prescriptions in Mitsui Memorial Hospital and in 13.5% of those in Sanraku Hospital. As to NSAIDs and antipyretic/analgesic drug, acetaminophen and acetaminophen preparations were most frequently prescribed (56.8%), and they were followed by loxoprofen sodium and mefenamic acid. We also surveyed cephem prescriptions at the same time. Cephems were prescribed for concurrent therapy with NSAIDs and/or antipyretic/analgesic drugs in 58.3% of outpatient cephem prescriptions (47.9% of all cephem prescriptions). These results showed that concurrent therapy with quinolones and NSAIDs is prescribed in clinical practice. The safety of such combination therapy should be established, and the interactions between these drugs should be clarified separately.