Use of fluoroquinolones and third-generation cephalosporins in the emergency department: an 11-year survey.
Fluoroquinolones and third-generation cephalosporins are particularly prone to select bacterial resistance to antibiotics. We aimed to assess the temporal trends of antibiotic use in the emergency department adults unit of an academic hospital between 2002 and 2012. Antibiotic use was converted in defined daily doses (DDD). The total antibiotic consumption tended to decrease, from 53.1±8.5 to 48.6±11.9 DDD/1000 patient visits (estimate decrease per year, -0.9±0.5 DDD/1000 visits, P=0.07). Use of third-generation cephalosporins increased significantly, from 9.7% of total antibiotic use to 22.6% (estimate per year, 1.2±0.2%, P<0.0001), whereas use of fluoroquinolones decreased from 19.5 to 12.3% (estimate per year, -0.7±0.2%, P<0.003). Given their ability to select bacterial resistance, especially extended-spectrum β-lactamases, particular attention should be paid to increasing use of third-generation cephalosporins in the emergency department.
aLaboratory EA3826 Therapeutiques cliniques et experimentales des infections bLaboratory EA3826 4275 Biostatistique recherche clinique et mesures subjectives en sante, Faculty of Medicine, University of Nantes cNantes University Hospital, Microbiology Laboratory dNantes University Hospital, Emergency Department, Nantes, France.
Emmanuel
E
Montassier
Stephane
S
Corvec
Jean-Benoit
JB
Hardouin
Gilles
G
Potel
Eric
E
Batard
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000453:epidemiology; D002511:Cephalosporins / Q000627:therapeutic use*; D004636:Emergency Service, Hospital; D024841:Fluoroquinolones / Q000627:therapeutic use*; D005602:France; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D012141:Respiratory Tract Infections / Q000188:drug therapy; D014552:Urinary Tract Infections / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D024841:Fluoroquinolones