[Evaluation of in-hospital prescription of fluoroquinolones]

Quinolones are widely prescribed in various hospital departments (about 20% of antibiotics prescriptions in some of them) and antibiotic resistances is increasingly documented. The aim of this prospective study was to assess the prescriptions of quinolones in several departments of medicine of Rouen University Hospital and compare them to the guidelines of good medical practice for antibiotic prescriptions.

This study was performed in four medicine departments during two months. When a physician prescribed a quinolone treatment, he had to record informations regarding the infection (type and site, bacteriological proof or not), the patient (age, sex and glomerular filtration rate) and the prescription of quinolone (indication, dosage, administration, combination with another antibiotic, duration of treatment).

A hundred and three prescriptions of quinolones were analysed (mean age 75+/-0.5 years). Quinolones treatments were more often used alone, in first intention and without bacteriological proof. The dosage of quinolones was generally adapted but the duration of treatment was often excessive. Quinolones prescriptions were in majority in accordance with the guidelines for pulmonary infections, but were more often inappropriate for urinary infections.

According to the infections, this study shows discrepancies with the published guidelines with respect to prescription of quinolones, but there are also differences between available guidelines that may at least in part explain our results. An harmonization and a large diffusion of uniform guidelines could improve patients antibiotherapy.