[Fluoroquinolones use at the Saint-Louis Hospital: investigations before and after diffusion of recommendations and interventions of the anti-infectious referent].
OBJECTIVE
The increase of bacterial resistance and of fluoroquinolones consumption led to set up an action plan in order to improve the use of fluoroquinolones.


METHODS
Two audits "on a given day" in February 2005 (before action) and January 2007 (after action) allowed evaluating the effects of several interventions: restitution of the results from the first audit and antibiotics counselling by an infectious diseases expert, conception and diffusion of local recommendations and follow-up of antibiotic consumption.


RESULTS
The prevalence of the fluoroquinolones' prescriptions was 49/503 hospitalized patients in 2005 (1st audit) and 30/482 in 2007 (2nd audit). Global conformity to the recommendations was 47% in 2005 and 40% in 2007. The number of inappropriate indications remained stable between 2005 (12, 25%) and 2007 (10, 33%) with a reduction in the use of fluoroquinolones for empirical treatments: 74% in 2005 and 50% in 2007. The use of the intravenous route decreased from 45% in 2005 to 27% in 2007. Consumption of antibiotics and fluoroquinolones decreased by 7% and 30% between 2005 and 2007 respectively.


CONCLUSIONS
The interventions allowed to decrease the use of fluoroquinolones in empirical treatments and to limit the use of the intravenous route. The impact on the fluoroquinolones and antibiotics consumption has been demonstrated. However, the proportion of inappropriate indications remained unchanged. The impact of the fluoroquinolones consumption decrease on the bacterial resistance will be the next step of our action.
Politis
B
B
Service de pharmacie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France. beatrice_didry@yahoo.fr
Pagnon
V
V
Lescot
C
C
Faure
P
P
Touratier
S
S
Lafaurie
M
M
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy; D003953:Diagnosis-Related Groups; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004352:Drug Resistance, Microbial; D004363:Drug Utilization; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000627:therapeutic use*; D019983:Guideline Adherence; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D055552:Infectious Disease Medicine / Q000592:standards; D033181:Information Dissemination; D007262:Infusions, Intravenous / Q000706:statistics & numerical data; D008485:Medical Audit; D016134:Organizational Policy; D010297:Paris / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D019564:Unnecessary Procedures
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones