Tehran University of Medical Sciences Iranian Journal of Microbiology 2008-3289 12 3 2020 05 29 177 184 Gholamhossein Hassanshahi Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Ali Darehkordi Department of Chemistry and Biophysics, School of Sciences, Vali-e-Asr University of Rafsanjan, Rafsanjan, Iran Mahmood Sheikh Fathollahi Department of Social Medicine, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Soudeh Khanamani Falahati-Pour Pistachio Safety Research Centre, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Ebrahim Rezazadeh Zarandi Department of Microbiology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Shokrollah Assar Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran AND Department of Microbiology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran 2019 07 03 2020 04 25 Fluoroquinolones (FQs) are widely used in the treatment of infections caused by Escherichia coli. FQs are broad spectrum antibiotics with high tissue penetration, and ease of use. Therefore, given the concerns existing about drug resistance, we aim to review the latest findings about resistance patterns to levofloxacin (LVX) along with other FQs in E. coli infections in different parts of Iran. Evidence shows that quinolones have been used in Iran for nearly 50 years, and that 0-65% of E. coli isolates show resistance to FQs. In the western parts of Iran, the highest rate of resistance to LVX (66.7%) has been reported among patients having urinary tract infections with E. coli isolates. Few studies and information exist on the antimicrobial resistance of E. coli to LVX in different geographical locations of Iran. However, the findings of various studies on this subject show that E. coli resistance to LVX is more in the western part of Iran than in central and southern regions, but it is similar among inpatients and outpatients. Therefore, it is reasonable advisable to limit the overuse, inappropriate prescription, and self-medication of LVX to prevent the induction of FQ-resistant strains. Accordingly, in order to obtain a clearer image of resistance to FQs, especially LVX in E. coli in Iran, more extensive investigations in different geographical locations and periods of time are required. In addition, antimicrobial stewardship would be helpful in this regard. https://ijm.tums.ac.ir/index.php/ijm/article/view/2241 https://ijm.tums.ac.ir/index.php/ijm/article/download/2241/1238