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Impact of restricting fluoroquinolone prescription on bacterial resistance in an intensive care unit

G Aubert1, A Carricajo, A-C Vautrin

  • 1Bacteriology Department, Bellevue University Hospital, Saint-Etienne, France. gerald.aubert@chu-st-etienne.fr

The Journal of Hospital Infection
|December 29, 2004
PubMed

Insights

Reducing fluoroquinolone prescriptions in intensive care units (ICUs) significantly improved Pseudomonas aeruginosa sensitivity to ciprofloxacin. This antibiotic stewardship strategy shows promise for managing bacterial resistance.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Critical Care Medicine

Background:

  • Antibiotic resistance is a growing threat in intensive care units (ICUs).
  • Fluoroquinolones are broad-spectrum antibiotics, and their overuse contributes to resistance.
  • Pseudomonas aeruginosa is a common ICU pathogen frequently associated with antibiotic resistance.

Purpose of the Study:

  • To evaluate the impact of reduced fluoroquinolone prescribing on bacterial resistance in an ICU.
  • To specifically assess changes in resistance patterns of Pseudomonas aeruginosa.

Main Methods:

  • A six-month period of restricted fluoroquinolone use was implemented in an ICU.
  • Bacteriological screening of patients was conducted before and after the restriction period.
  • Prescription data and bacterial resistance rates, particularly for P. aeruginosa and ciprofloxacin, were analyzed.

Main Results:

  • Fluoroquinolone prescriptions were reduced by 75.8%.
  • A significant increase in P. aeruginosa sensitivity to ciprofloxacin was observed (71.3% resistance pre-restriction vs. 52.4% post-restriction).
  • No significant changes in overall bacterial ecology were noted, but ventilator-associated pneumonia cases with ciprofloxacin-resistant P. aeruginosa decreased.

Conclusions:

  • Restricting fluoroquinolone use in ICUs can effectively reduce resistance in key pathogens like P. aeruginosa.
  • Antibiotic rotation or stewardship programs are feasible and beneficial in ICU settings.
  • This approach can help preserve the efficacy of important antibiotics for patient care.

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