Residents and Fellows Research in Progress
Tuesday, November 14, 2023
08:30 AM–10:00 AM
Abstract
Introduction: Fluoroquinolones are widely used despite FDA safety warnings about disabling and potentially permanent side effects such as tendon rupture, delirium, and peripheral neuropathy. In recent years, high resistance rates among gram-negative pathogens to fluoroquinolones were seen in our institution's antibiograms. Restriction of fluoroquinolones is important to increase fluoroquinolone susceptibility to gram-negative pathogens, prevent development of multi-drug resistant organisms, and reduce collateral damage.
Research Question or Hypothesis: Can fluoroquinolones restriction guidelines be instituted to minimize inappropriate use without negatively affecting patient outcomes?
Study Design: A prospective interventional study at an academic Level I Trauma hospital. Pre-intervention period: June 2022 to November 2022, post-intervention period: April 2023 to June 2023
Methods: Restricted fluoroquinolone criteria were implemented after P&T committee and IRB approval. All prescribers were educated on use criteria. Pre-and post-intervention data was collected. Data was analyzed by t-tests with p-value < 0.05 to be considered statistically significant. Patients 18 years prescribed fluoroquinolones were included. Patients with allergies to fluoroquinolones or pregnant were excluded. The primary outcome was days of fluoroquinolone therapy. Secondary outcomes were adherence to the restricted use criteria and hospital length of stay.
Results: Overall appropriateness was 47% pre-intervention group (n=169) and 69% post-intervention group (n=58). Fewer mean days of fluroquinolone therapy was seen in post-intervention group compared to pre-intervention group (3.2 days vs. 4.14 days, respectively, with a mean difference of 0.94 days (p=0.06)). Mean hospital length of stay was lower in the post-intervention group (8.7 days) than in the pre-intervention group (11.8 days) (p=0.05).
Conclusion: Our study showed that fluoroquinolone restrictions can be safely implemented in a community based academic institution to promote antibiotic stewardship.
Presenting Author
Sehyun Jeong Pharm.DScripps Health
Authors
Harminder Sikand Pharm.D., FCSHP, FASHP, FCCP
Scripps Mercy Hospital
Eva Sullivan Pharm.D., BCIDP, APh
Scripps Mercy Hospital