A Nonrestrictive Approach to Fluoroquinolone Stewardship at Two Community Hospitals

Area of Science:

• Infectious Diseases
• Antimicrobial Stewardship
• Clinical Pharmacy

Background:

• Fluoroquinolones are widely prescribed but contribute to antibiotic resistance and adverse effects.
• Hospital antimicrobial stewardship programs often target fluoroquinolones to prevent overuse.
• This study examines nonrestrictive stewardship interventions' impact on levofloxacin use and resistance.

Purpose of the Study:

• To assess the association of nonrestrictive antimicrobial stewardship interventions with levofloxacin utilization.
• To evaluate changes in prescribing patterns of alternative antibiotics.
• To determine the impact on *Pseudomonas aeruginosa* nonsusceptibility rates to levofloxacin.

Main Methods:

• Nonrestrictive interventions included monitoring, feedback, guideline implementation, and prescriber education.
• Levofloxacin utilization and alternative antibiotic use were tracked from August 2015 to January 2021.
• Correlation between antibiotic use and *P. aeruginosa* nonsusceptibility was analyzed.

Main Results:

• Levofloxacin prescribing significantly decreased at both hospitals.
• A negative correlation was found between ceftriaxone and levofloxacin use (P < .0001).
• Levofloxacin use positively correlated with *P. aeruginosa* nonsusceptibility (P < .02).

Conclusions:

• Nonrestrictive stewardship effectively reduced levofloxacin utilization.
• The interventions led to increased ceftriaxone use and improved *P. aeruginosa* susceptibility.
• This approach demonstrates successful antimicrobial stewardship in community hospital settings.