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105. Fluoroquinolone Stewardship at a Community Health-System: A Decade in Review

BACKGROUND: Fluoroquinolone stewardship is a common target for antimicrobial stewardship programs seeking to maintain or improve fluoroquinolone susceptibility rates. Additional benefits include reducing C. difficile infection rates, drug toxicities, and resistance to other antimicrobials as fluoroq...

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Autores principales: Song, Matthew, Wilde, Ashley, Moore, Sarah E, Bohn, Brian C, Schulz, Paul S
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8645044/
http://dx.doi.org/10.1093/ofid/ofab466.307
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author Song, Matthew
Wilde, Ashley
Wilde, Ashley
Moore, Sarah E
Bohn, Brian C
Schulz, Paul S
author_facet Song, Matthew
Wilde, Ashley
Wilde, Ashley
Moore, Sarah E
Bohn, Brian C
Schulz, Paul S
author_sort Song, Matthew
collection PubMed
description BACKGROUND: Fluoroquinolone stewardship is a common target for antimicrobial stewardship programs seeking to maintain or improve fluoroquinolone susceptibility rates. Additional benefits include reducing C. difficile infection rates, drug toxicities, and resistance to other antimicrobials as fluoroquinolones can co-select for resistance. The Norton Healthcare antimicrobial stewardship program was founded in 2011 and provides services at 4 adult hospitals with ~1600 beds. Main fluoroquinolone stewardship activities have included provider education, prospective audit and feedback, and guideline and order-set development. The purpose of this study was to describe the resistance and usage rates of fluoroquinolones over time. METHODS: This was a descriptive study examining individual adult hospital antibiograms from 2010 to 2020. Levofloxacin susceptibility rates to E. coli and P. aeruginosa were collated from annual antibiograms between 2010 and 2020 for outpatients and each adult hospital. Adult hospital resistance rates were aggregated and weighted accordingly to number of isolates per hospital per year. Additionally, levofloxacin and ciprofloxacin inpatient days of therapy (DOT) was collected since 2016 when DOT was first readily retrievable and was normalized per 1000 patient days to compare between different time points. RESULTS: Outpatient levofloxacin likelihood of activity against P. aeruginosa improved from 81% to 91%. Outpatient levofloxacin likelihood of activity against E. coli remained stable between 84 – 86% (Figure 1). Adult inpatient fluoroquinolone usage decreased by approximately 75% from 83.5 to 21.37 DOT/1000 patient days since 2016 (Figure 2). Adult inpatient levofloxacin likelihood of activity against P. aeruginosa improved from 53% to 83%. Adult inpatient levofloxacin likelihood of activity against E. coli improved from 65% to 75% (Figure 3). [Image: see text] [Image: see text] [Image: see text] CONCLUSION: The Norton Healthcare antimicrobial stewardship program has been effective in reducing unnecessary fluoroquinolone usage and improving inpatient fluoroquinolone susceptibility rates. Future studies should examine opportunities to translate successes to the outpatient phase of care. DISCLOSURES: Ashley Wilde, PharmD, BCPS-AQ ID, Nothing to disclose Paul S. Schulz, MD, Gilead (Consultant, Speaker’s Bureau)Merck (Consultant, Speaker’s Bureau)
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spelling pubmed-86450442021-12-06 105. Fluoroquinolone Stewardship at a Community Health-System: A Decade in Review Song, Matthew Wilde, Ashley Wilde, Ashley Moore, Sarah E Bohn, Brian C Schulz, Paul S Open Forum Infect Dis Poster Abstracts BACKGROUND: Fluoroquinolone stewardship is a common target for antimicrobial stewardship programs seeking to maintain or improve fluoroquinolone susceptibility rates. Additional benefits include reducing C. difficile infection rates, drug toxicities, and resistance to other antimicrobials as fluoroquinolones can co-select for resistance. The Norton Healthcare antimicrobial stewardship program was founded in 2011 and provides services at 4 adult hospitals with ~1600 beds. Main fluoroquinolone stewardship activities have included provider education, prospective audit and feedback, and guideline and order-set development. The purpose of this study was to describe the resistance and usage rates of fluoroquinolones over time. METHODS: This was a descriptive study examining individual adult hospital antibiograms from 2010 to 2020. Levofloxacin susceptibility rates to E. coli and P. aeruginosa were collated from annual antibiograms between 2010 and 2020 for outpatients and each adult hospital. Adult hospital resistance rates were aggregated and weighted accordingly to number of isolates per hospital per year. Additionally, levofloxacin and ciprofloxacin inpatient days of therapy (DOT) was collected since 2016 when DOT was first readily retrievable and was normalized per 1000 patient days to compare between different time points. RESULTS: Outpatient levofloxacin likelihood of activity against P. aeruginosa improved from 81% to 91%. Outpatient levofloxacin likelihood of activity against E. coli remained stable between 84 – 86% (Figure 1). Adult inpatient fluoroquinolone usage decreased by approximately 75% from 83.5 to 21.37 DOT/1000 patient days since 2016 (Figure 2). Adult inpatient levofloxacin likelihood of activity against P. aeruginosa improved from 53% to 83%. Adult inpatient levofloxacin likelihood of activity against E. coli improved from 65% to 75% (Figure 3). [Image: see text] [Image: see text] [Image: see text] CONCLUSION: The Norton Healthcare antimicrobial stewardship program has been effective in reducing unnecessary fluoroquinolone usage and improving inpatient fluoroquinolone susceptibility rates. Future studies should examine opportunities to translate successes to the outpatient phase of care. DISCLOSURES: Ashley Wilde, PharmD, BCPS-AQ ID, Nothing to disclose Paul S. Schulz, MD, Gilead (Consultant, Speaker’s Bureau)Merck (Consultant, Speaker’s Bureau) Oxford University Press 2021-12-04 /pmc/articles/PMC8645044/ http://dx.doi.org/10.1093/ofid/ofab466.307 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Poster Abstracts
Song, Matthew
Wilde, Ashley
Wilde, Ashley
Moore, Sarah E
Bohn, Brian C
Schulz, Paul S
105. Fluoroquinolone Stewardship at a Community Health-System: A Decade in Review
title 105. Fluoroquinolone Stewardship at a Community Health-System: A Decade in Review
title_full 105. Fluoroquinolone Stewardship at a Community Health-System: A Decade in Review
title_fullStr 105. Fluoroquinolone Stewardship at a Community Health-System: A Decade in Review
title_full_unstemmed 105. Fluoroquinolone Stewardship at a Community Health-System: A Decade in Review
title_short 105. Fluoroquinolone Stewardship at a Community Health-System: A Decade in Review
title_sort 105. fluoroquinolone stewardship at a community health-system: a decade in review
topic Poster Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8645044/
http://dx.doi.org/10.1093/ofid/ofab466.307
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