title: Longitudinal surveillance of outpatient quinolone antimicrobial use in Canada.
abstract: BACKGROUND
  Because antimicrobial use is commonly associated with the development of antimicrobial resistance, monitoring the volume and patterns of use of these agents is important.
  
  
  OBJECTIVE
  To assess the use of quinolone antimicrobials within Canadian provinces over time.
  
  
  METHODS
  ANTIMICROBIAL PRESCRIBING DATA COLLECTED BY IMS HEALTH CANADA WERE ACQUIRED FROM THE CANADIAN INTEGRATED PROGRAM FOR ANTIMICROBIAL RESISTANCE SURVEILLANCE AND THE CANADIAN COMMITTEE FOR ANTIMICROBIAL RESISTANCE, AND WERE USED TO CALCULATE TWO YEARLY METRICS: prescriptions per 1000 inhabitant-days and the mean defined daily doses (DDDs) per prescription. These measures were used to produce linear mixed models to assess differences among provinces and over time, while accounting for repeated measurements.
  
  
  RESULTS
  The quinolone class of antimicrobials is used similarly among Canadian provinces. Year-to-year increases in quinolone prescribing occurred from 1995 to 2010, with a levelling off in the latter years. Year-to-year decreases in the DDDs per prescription were found to be significant from 2000 to 2010.
  
  
  CONCLUSIONS
  Although the overall use of antimicrobials differs significantly among Canadian provinces, the use of the quinolone class does not vary at the provincial level. Results suggest that prescribing of ciprofloxacin may be a potential target for antimicrobial stewardship programs; however, decreases in the average DDDs per prescription suggest continued uptake of appropriate treatment guidelines.
authors.affiliation: Public Health Agency of Canada, Centre for Food-borne, Environmental and Zoonotic Infectious Diseases, Guelph, Ontario;
authors.forename: Shiona K
authors.initials: SK
authors.lastname: Glass-Kaastra
authors.affiliation: Public Health Agency of Canada, Centre for Food-borne, Environmental and Zoonotic Infectious Diseases, Guelph, Ontario;
authors.forename: Rita
authors.initials: R
authors.lastname: Finley
authors.affiliation: Division of Medical Microbiology, Island Medical Program, University of British Columbia;
authors.forename: Jim
authors.initials: J
authors.lastname: Hutchinson
authors.affiliation: British Columbia Centre for Disease Control, Vancouver, British Columbia; ; University of British Columbia, School of Population and Public Health, Vancouver, British Columbia;
authors.forename: David M
authors.initials: DM
authors.lastname: Patrick
authors.affiliation: University of Montreal, Department of Infectious Diseases and Microbiology, Hôpital Maisonneuve-Rosemont, Montreal, Quebec;
authors.forename: Karl
authors.initials: K
authors.lastname: Weiss
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta ; Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta ; Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta.
authors.forename: John
authors.initials: J
authors.lastname: Conly
keywords: Antimicrobial use; Drug utilization; Quinolones; Surveillance