https://www.cidrap.umn.edu/news-per...ial-stewardship-tied-less-fluoroquinolone-use
Antimicrobial stewardship tied to less fluoroquinolone use
Filed Under:
Antimicrobial Stewardship
Implementation of an antimicrobial stewardship program (ASP) across a four-hospital health system was linked to a substantial decrease in the use of fluoroquinolones and increased susceptibility of Pseudomonas aeruginosa and Escherichia coli to levofloxacin, finds a study published yesterday in Antimicrobial Stewardship & Healthcare Epidemiology.
Kentucky-based Norton Healthcare researchers led the analysis of fluoroquinolone use and antimicrobial susceptibility among hospitalized adults in the 10 years after ASP implementation, which was spearheaded by an infectious diseases pharmacist in 2011. Each quarter from 2016 to 2020, the team calculated and reported fluoroquinolone use by days of therapy (DOT) per 1,000 patient-days. P aeruginosa and E coli susceptibility were reported from 2011 to 2020.
The ASP initially focused on formulary optimization, guidelines for optimal antimicrobial use, updates to order sets (grouping of orders to standardize and expedite drug ordering), and clinician and pharmacist education. Later, it focused on providing audit and feedback for patients who were taking broad-spectrum antimicrobials. Routine fluoroquinolone use was discouraged mainly through order-set revisions.
Fluoroquinolone use fell 74% over the 5-year period, with an average decrease of 3.45 DOT per 1,000 patient-days per quarter. Over 10 years, levofloxacin susceptibility rose 57% for P aeruginosa and 15% for E coli. On average, P aeruginosa susceptibility to levofloxacin climbed 2.7% each year and had a strong negative correlation with fluoroquinolone use. E coli susceptibility to levofloxacin rose, on average, 1.3% each year and also was negatively correlated with fluoroquinolone use.
The authors noted that antimicrobial resistance, driven by inappropriate use of antimicrobial drugs, is a public health threat. Fluoroquinolone, for example, has been widely prescribed for many different types of infections, including those that may have been more appropriately treated with an alternative drug. Fluoroquinolones, they said, are the only antibiotic class available for enteral (via the gastrointestinal tract) administration for the treatment of Pseudomonas infections.
"These results demonstrate the value of stewardship services and highlight the effectiveness of an infectious diseases pharmacist led antimicrobial stewardship program," they wrote.
Antimicrobial stewardship tied to less fluoroquinolone use
Filed Under:
Antimicrobial Stewardship
Implementation of an antimicrobial stewardship program (ASP) across a four-hospital health system was linked to a substantial decrease in the use of fluoroquinolones and increased susceptibility of Pseudomonas aeruginosa and Escherichia coli to levofloxacin, finds a study published yesterday in Antimicrobial Stewardship & Healthcare Epidemiology.
Kentucky-based Norton Healthcare researchers led the analysis of fluoroquinolone use and antimicrobial susceptibility among hospitalized adults in the 10 years after ASP implementation, which was spearheaded by an infectious diseases pharmacist in 2011. Each quarter from 2016 to 2020, the team calculated and reported fluoroquinolone use by days of therapy (DOT) per 1,000 patient-days. P aeruginosa and E coli susceptibility were reported from 2011 to 2020.
The ASP initially focused on formulary optimization, guidelines for optimal antimicrobial use, updates to order sets (grouping of orders to standardize and expedite drug ordering), and clinician and pharmacist education. Later, it focused on providing audit and feedback for patients who were taking broad-spectrum antimicrobials. Routine fluoroquinolone use was discouraged mainly through order-set revisions.
Fluoroquinolone use fell 74% over the 5-year period, with an average decrease of 3.45 DOT per 1,000 patient-days per quarter. Over 10 years, levofloxacin susceptibility rose 57% for P aeruginosa and 15% for E coli. On average, P aeruginosa susceptibility to levofloxacin climbed 2.7% each year and had a strong negative correlation with fluoroquinolone use. E coli susceptibility to levofloxacin rose, on average, 1.3% each year and also was negatively correlated with fluoroquinolone use.
The authors noted that antimicrobial resistance, driven by inappropriate use of antimicrobial drugs, is a public health threat. Fluoroquinolone, for example, has been widely prescribed for many different types of infections, including those that may have been more appropriately treated with an alternative drug. Fluoroquinolones, they said, are the only antibiotic class available for enteral (via the gastrointestinal tract) administration for the treatment of Pseudomonas infections.
"These results demonstrate the value of stewardship services and highlight the effectiveness of an infectious diseases pharmacist led antimicrobial stewardship program," they wrote.
