title: Changes in fluoroquinolone use for gonorrhea following publication of revised treatment guidelines.
abstract: OBJECTIVE
  We evaluated the impact of revised national treatment recommendations on fluoroquinolone use for gonorrhea in selected states.
  
  
  METHODS
  We evaluated gonorrhea cases reported through the Sexually Transmitted Disease Surveillance Network as treated between July 1, 2006 and May 31, 2008, using interrupted time series analysis. Outcomes were fluoroquinolone treatment overall, by area, and by practice setting.
  
  
  RESULTS
  Of 16,126 cases with treatment dates in this period, 15,669 noted the medication used. After revised recommendations were released, fluoroquinolone use decreased abruptly overall (21.5%; 95% confidence interval [CI] = 15.9%, 27.2%), in most geographic areas evaluated, and in sexually transmitted disease clinics (28.5%; 95% CI = 19.0%, 37.9%). More gradual decreases were seen in primary care (8.6%; 95% CI = 2.6%, 14.6%), and in emergency departments, urgent care, and hospitals (2.7%; 95% CI = 1.7%, 3.7%).
  
  
  CONCLUSIONS
  Fluoroquinolone use decreased after the publication of revised national guidelines, particularly in sexually transmitted disease clinics. Additional mechanisms are needed to increase the speed and magnitude of changes in prescribing in primary care, emergency departments, urgent care, and hospitals.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Dowell
authors.forename: Lin H
authors.initials: LH
authors.lastname: Tian
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Stover
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Donnelly
authors.forename: Summer
authors.initials: S
authors.lastname: Martins
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Erbelding
authors.forename: Raul
authors.initials: R
authors.lastname: Pino
authors.forename: Hillard
authors.initials: H
authors.lastname: Weinstock
authors.forename: Lori M
authors.initials: LM
authors.lastname: Newman
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D024841:Fluoroquinolones / Q000627:therapeutic use*; D006069:Gonorrhea / Q000188:drug therapy* / Q000453:epidemiology; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones
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