Impact of Intervention by an Antimicrobial Stewardship Team on Conversion from Intravenous to Oral Fluoroquinolones.
BACKGROUND
Early conversion from intravenous to oral antibiotics plays an important role in lowering the risk of catheter-associated infections, reducing the workload of nurses, decreasing direct and indirect costs, and shortening hospital stays. In August 2015, an antimicrobial stewardship program (ASP) was implemented to facilitate conversion from intravenous to oral administration of fluoroquinolones in our institute. This study evaluated the clinical and economic impact of the intervention.


METHODS
Data were retrospectively collected by reviewing electronic medical records. All hospitalized patients aged 18 and older who met the study inclusion criteria for the conversion were included between August and November 2015. We computed the physicians' adherence rate to the ASP recommendations. We also measured the total use of fluoroquinolones, length of hospital stay, and medication costs.


RESULTS
During 4 months, 129 cases were enrolled in the study. The adherence rate was 79.8%. The average total prescription volume of intravenous fluoroquinolones, the length of hospital stay, and the total cost of the fluoroquinolones statistically significantly decreased in the intervention-adherent group.


CONCLUSIONS
Intervention to facilitate conversion from intravenous to oral administration has reduced excess use of intravenous fluoroquinolones and length of hospital stay. With these findings, further implementations of the ASP extending to other antibiotics may be warranted.
Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, Korea.
Soh Mee
http://orcid.org/0000-0001-6472-2633
SM
Park
Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, Korea.
Hyung Sook
http://orcid.org/0000-0002-6385-9619
HS
Kim
Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, Korea.
Young Mi
YM
Jeong
Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, Korea.
Jung Hwa
JH
Lee
Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, Korea.
Eunsook
E
Lee
College of Pharmacy, Seoul National University, Seoul, Korea.
Euni
http://orcid.org/0000-0002-4487-4450
E
Lee
Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Kyoung Ho
http://orcid.org/0000-0002-4517-3840
KH
Song
Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Hong Bin
http://orcid.org/0000-0001-6262-372X
HB
Kim
Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. eskim@snubh.org.
Eu Suk
http://orcid.org/0000-0001-7132-0157
ES
Kim
Antimicrobial stewardship; Fluoroquinolones; Intervention; Oral antibiotics