Stewardship Programs Decrease Inpatient Fluoroquinolone Rx
Interventions tied to less prescribing in hospital but did not impact fluoroquinolone discharge treatment
WEDNESDAY, Feb. 27, 2019 (Pharmacist's Briefing) -- Fluoroquinolone stewardship interventions at hospitals are associated with less fluoroquinolone prescribing during hospitalization but not at discharge, according to a study published online Feb. 13 in Clinical Infectious Diseases.
Valerie M. Vaughn, M.D., from the Veterans Affairs Ann Arbor Health System in Michigan, and colleagues retrospectively reviewed prescribing for medical patients treated at 48 hospitals for pneumonia (6,820 patients) or positive urine culture (4,928 patients) from December 2015 through September 2017.
The researchers found that 14 of the 48 hospitals reported using pre-prescription approval and/or prospective audit and feedback to target fluoroquinolone prescribing. Fluoroquinolone stewardship was associated with fewer patients receiving a fluoroquinolone (37.1 versus 48.2 percent) and fewer fluoroquinolone treatment days per 1,000 patients (2,282 versus 3,096), driven by lower inpatient prescribing and after adjustment for other factors. However, 66.6 percent of fluoroquinolone treatment days occurred after discharge. Hospitals with fluoroquinolone stewardship had twice as many new fluoroquinolone starts after discharge versus hospitals without fluoroquinolone stewardship (15.6 versus 8.4 percent).
"To limit aggregate fluoroquinolone exposure, stewardship programs should target both inpatient and discharge prescribing," the authors write.
Blue Cross and Blue Shield of Michigan provided funding for the study.