Fluoroquinolone stewardship at a community health system: A decade in review
Abstract Objective: To describe inpatient fluoroquinolone use and susceptibility data over a 10-year period after the implementation of an antimicrobial stewardship program (ASP) led by an infectious diseases pharmacist starting in 2011. Design: Retrospective surveillance study. Setting: Large...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-01-01
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| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X22003266/type/journal_article |
| _version_ | 1811157196018286592 |
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| author | Elena A. Swingler Matthew Song Sarah E. Moore Brian C. Bohn Paul S. Schulz Alan D. Junkins Ashley M. Wilde |
| author_facet | Elena A. Swingler Matthew Song Sarah E. Moore Brian C. Bohn Paul S. Schulz Alan D. Junkins Ashley M. Wilde |
| author_sort | Elena A. Swingler |
| collection | DOAJ |
| description |
Abstract
Objective:
To describe inpatient fluoroquinolone use and susceptibility data over a 10-year period after the implementation of an antimicrobial stewardship program (ASP) led by an infectious diseases pharmacist starting in 2011.
Design:
Retrospective surveillance study.
Setting:
Large community health system.
Methods:
Fluoroquinolone use was quantified by days of therapy (DOT) per 1,000 patient days (PD) and reported quarterly. Use data are reported for inpatients from 2016 to 2020. Levofloxacin susceptibility is reported for Pseudomonas aeruginosa and Escherichia coli for inpatients from 2011 to 2020 at a 4 adult-hospital health system.
Results:
Inpatient fluoroquinolone use decreased by 74% over a 5-year period, with an average decrease of 3.45 DOT per 1,000 PD per quarter (P < .001). Over a 10-year period, inpatient levofloxacin susceptibility increased by 57% for P. aeruginosa and by 15% for E. coli. P. aeruginosa susceptibility to levofloxacin increased by an average of 2.73% per year (P < .001) and had a strong negative correlation with fluoroquinolone use, r = −0.99 (P = .002). E. coli susceptibility to levofloxacin increased by an average of 1.33% per year (P < .001) and had a strong negative correlation with fluoroquinolone use, r = −0.95 (P = .015).
Conclusions:
A substantial decrease in fluoroquinolone use and increase in P. aeruginosa and E. coli levofloxacin susceptibility was observed after implementation of an antimicrobial stewardship program. These results demonstrate the value of stewardship services and highlight the effectiveness of an infectious diseases pharmacist led antimicrobial stewardship program.
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| first_indexed | 2024-04-10T05:01:52Z |
| format | Article |
| id | doaj.art-e9a9dbb87a1b42478ee21af302270ef1 |
| institution | Directory Open Access Journal |
| issn | 2732-494X |
| language | English |
| last_indexed | 2024-04-10T05:01:52Z |
| publishDate | 2022-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj.art-e9a9dbb87a1b42478ee21af302270ef12023-03-09T12:28:17ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2022-01-01210.1017/ash.2022.326Fluoroquinolone stewardship at a community health system: A decade in reviewElena A. Swingler0https://orcid.org/0000-0003-4288-955XMatthew Song1https://orcid.org/0000-0001-8634-6421Sarah E. Moore2https://orcid.org/0000-0002-3382-2735Brian C. Bohn3https://orcid.org/0000-0002-8458-7800Paul S. Schulz4Alan D. Junkins5Ashley M. Wilde6https://orcid.org/0000-0001-8459-0025Norton Infectious Diseases Institute, Norton Healthcare, Louisville, KentuckyNorton Infectious Diseases Institute, Norton Healthcare, Louisville, KentuckyNorton Infectious Diseases Institute, Norton Healthcare, Louisville, KentuckyDepartment of Pharmacy, Barnes-Jewish Hospital, St. Louis, MissouriNorton Infectious Diseases Institute, Norton Healthcare, Louisville, KentuckyDepartment of Microbiology, Norton Healthcare, Louisville, KentuckyNorton Infectious Diseases Institute, Norton Healthcare, Louisville, Kentucky Abstract Objective: To describe inpatient fluoroquinolone use and susceptibility data over a 10-year period after the implementation of an antimicrobial stewardship program (ASP) led by an infectious diseases pharmacist starting in 2011. Design: Retrospective surveillance study. Setting: Large community health system. Methods: Fluoroquinolone use was quantified by days of therapy (DOT) per 1,000 patient days (PD) and reported quarterly. Use data are reported for inpatients from 2016 to 2020. Levofloxacin susceptibility is reported for Pseudomonas aeruginosa and Escherichia coli for inpatients from 2011 to 2020 at a 4 adult-hospital health system. Results: Inpatient fluoroquinolone use decreased by 74% over a 5-year period, with an average decrease of 3.45 DOT per 1,000 PD per quarter (P < .001). Over a 10-year period, inpatient levofloxacin susceptibility increased by 57% for P. aeruginosa and by 15% for E. coli. P. aeruginosa susceptibility to levofloxacin increased by an average of 2.73% per year (P < .001) and had a strong negative correlation with fluoroquinolone use, r = −0.99 (P = .002). E. coli susceptibility to levofloxacin increased by an average of 1.33% per year (P < .001) and had a strong negative correlation with fluoroquinolone use, r = −0.95 (P = .015). Conclusions: A substantial decrease in fluoroquinolone use and increase in P. aeruginosa and E. coli levofloxacin susceptibility was observed after implementation of an antimicrobial stewardship program. These results demonstrate the value of stewardship services and highlight the effectiveness of an infectious diseases pharmacist led antimicrobial stewardship program. https://www.cambridge.org/core/product/identifier/S2732494X22003266/type/journal_article |
| spellingShingle | Elena A. Swingler Matthew Song Sarah E. Moore Brian C. Bohn Paul S. Schulz Alan D. Junkins Ashley M. Wilde Fluoroquinolone stewardship at a community health system: A decade in review Antimicrobial Stewardship & Healthcare Epidemiology |
| title | Fluoroquinolone stewardship at a community health system: A decade in review |
| title_full | Fluoroquinolone stewardship at a community health system: A decade in review |
| title_fullStr | Fluoroquinolone stewardship at a community health system: A decade in review |
| title_full_unstemmed | Fluoroquinolone stewardship at a community health system: A decade in review |
| title_short | Fluoroquinolone stewardship at a community health system: A decade in review |
| title_sort | fluoroquinolone stewardship at a community health system a decade in review |
| url | https://www.cambridge.org/core/product/identifier/S2732494X22003266/type/journal_article |
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