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A hopeless pharmacist, hopeless patient, and a hopeless nation.

With quinolones and fluoroquinolones joining the list of most drugs marked to have dangerous advance drug effects, it’s also important to remember that these classes of antibiotics are the most widely used antibiotics both in private and public health facilities. Statistically, drugs such as ciprofloxacin seem to be more sensitive to some organisms compared to other antibiotics from various classes.

While restrictions on the use of these antibiotics have been officially communicated, the question which remains an answered is, what is the exposure frequency for one to develop the said advance effects? What amount of dosage is known to cause these advance effects? Can a 5-day treatment of ciprofloxacin 500mg lead to tendonitis?

Last year we had a warning on the use of diclofenac injections/tablets and ibuprofen due to associated cardiac advance effect, of which still they are widely and heavily used in 95℅ of our Kenyan health facilities! The same year there was an advisory to stop using ceftriaxone due to massive resistance associated with its use. This is the question; where is the Kenyan pharmacist in all these development? Where are the round table discussions from various pharmacists consultants in various specialties? What are the Clinical pharmacists telling the regulator and the Wanjiku about these announcements?

Yes, the quinolones have the said advance effects, but is there anything that can be done to evade the occurrence of these advance effects when a patient is put on these molecules? What duration of use can lead to the occurrence of the said advance effects? Where are the industrial pharmacists’ consultants? Is there anything that can be done on formulation and delivery to evade these potential advance effects? Can we see them in a round table brainstorming on the way forward helping the regulator come up with solutions! Where are the Clinical Toxicologists on this matter? Can they submit their statement of discussion to the regulator for brainstorming? Where are the academic and research pharmacists as well?

The regulator will be more than happy to receive local findings from them regarding the use of the said molecules. Instead, what we have embraced is a BREAKING NEWS phenomenon for both the experts and the patient, while ciprofloxacin, levofloxacin, moxifloxacin, ceftriaxone, and diclofenac continue to be prescribed, bought, distributed and administered in large volumes. My conclusion, if these research findings of the said molecules are valid, then there is a need to come up with suggestions for structure modifications or a synergistic approach. Otherwise wiping out quinolones and fluoroquinolones from the prescriber’s ink or community pharmacy shelves will need great dreamers like the Alexandria the Great

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