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Restriction-free antimicrobial stewardship initiative targeting fluoroquinolone reduction across a regional
Jacinta Chin1, Sarah B Green1, Lacie J McKamey1
1Novant Health, Department of Pharmacy, USA.
Background:
Fluoroquinolone (FQ) antibiotics have become a target of many antimicrobial stewardship programmes. Multiple post-marketing warnings from the Food and Drug Administration caution against use of this drug class for certain infections due to risk of harmful adverse effects outweighing benefit. Commonly employed strategies to affect antibiotic prescribing can be restrictive and without improvement in overall antibiotic appropriateness or decrease in collateral damage.
Aim:
To develop a strategy for sustainable optimization of FQ antibiotics.
Setting:
Multi-state health-system of 14 hospitals and medical centers.
Methods:
The health-system antimicrobial stewardship program identified the opportunity to improve FQ utilization. In collaboration with our data and analytics team, specific targets of FQ use in pneumonia and chronic obstructive pulmonary disease were established. Face-to-face provider education and prospective audit and feedback were the mainstays of the campaign. Enhancements to the electronic medical record to support the initiative were also implemented.
Findings:
There was an overall decrease in FQ utilization by 56.9%. For pneumonia use of FQs decreased from 16.4% to 8.1% and in COPD changed from 29.6% to 9.7% over the same time period.
Conclusions:
A non-restrictive FQ optimization initiative based on education and feedback decreased both FQ consumption and total antibiotic use across a large multi-hospital health-system.
Insights
A non-restrictive strategy using education and feedback significantly reduced fluoroquinolone (FQ) antibiotic use by 56.9% across 14 hospitals. This optimization initiative also decreased overall antibiotic consumption.
Area of Science:
- Antimicrobial Stewardship
- Health Systems Pharmacy
- Infectious Diseases
Background:
- Fluoroquinolone (FQ) antibiotics face scrutiny due to safety concerns, prompting antimicrobial stewardship interventions.
- Existing strategies to curb FQ use are often restrictive and may not improve appropriateness or reduce collateral damage.
- Post-marketing warnings highlight risks associated with FQ use, necessitating optimized prescribing practices.
Purpose of the Study:
- To develop and implement a sustainable strategy for optimizing fluoroquinolone (FQ) antibiotic utilization.
- To reduce FQ prescribing without resorting to restrictive measures.
Main Methods:
- A multi-state health system comprising 14 hospitals and medical centers implemented the initiative.
- The strategy involved provider education, prospective audit and feedback, and electronic medical record enhancements.
- Specific targets for FQ use in pneumonia and chronic obstructive pulmonary disease (COPD) were established.
Main Results:
- Overall FQ utilization decreased by 56.9% across the health system.
- FQ use for pneumonia dropped from 16.4% to 8.1%.
- FQ use for COPD decreased from 29.6% to 9.7%.
Conclusions:
- A non-restrictive optimization initiative effectively reduced FQ consumption.
- The strategy, centered on education and feedback, also led to a decrease in total antibiotic use.
- This approach proved successful in a large, multi-hospital health system.
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