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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
An antimicrobial stewardship program with a focus on reducing fluoroquinolone overuse.
Annie Wong-Beringer1, Lee H Nguyen, Michelle Lee
1School of Pharmacy, University of Southern California, Los Angeles, California 90033, USA. anniew@usc.edu
Pharmacotherapy
|May 30, 2009
Summary
A pharmacist-led antimicrobial stewardship program successfully reduced fluoroquinolone prescribing by 30%. This initiative improved bacterial susceptibility and halved mortality from Pseudomonas aeruginosa infections.
Area of Science:
- Pharmacology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Fluoroquinolones are widely prescribed in the US, leading to rapid development of pathogen resistance.
- Increased fluoroquinolone use correlates with rising antimicrobial resistance, impacting patient outcomes.
Purpose of the Study:
- To describe a pharmacist-led antimicrobial stewardship program aimed at reducing inappropriate fluoroquinolone prescribing.
- To limit the development of antimicrobial resistance and enhance patient outcomes.
Main Methods:
- Regular monitoring and reporting of resistance trends using institutional antibiograms.
- Drug audits with prescriber feedback, parenteral-to-oral conversion programs, and guideline implementation.
- Educational initiatives for prescribers on appropriate antimicrobial use.
Main Results:
- Reduced empiric fluoroquinolone prescribing by 30%.
- Improved susceptibility of Pseudomonas aeruginosa to antipseudomonal agents by 10%.
- Decreased mortality associated with P. aeruginosa infections by twofold.
Conclusions:
- Pharmacist-led stewardship programs can effectively reduce inappropriate antimicrobial prescribing.
- These programs positively influence antimicrobial prescribing patterns at the institutional level.
- Antimicrobial stewardship improves patient outcomes and combats resistance development.
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