HealthDay News — Fluoroquinolone stewardship interventions at hospitals are associated with less fluoroquinolone prescribing during hospitalization but not at discharge, according to a study published online February 13 in Clinical Infectious Diseases.
Valerie M. Vaughn, MD, from the Veterans Affairs Ann Arbor Health System in Michigan, and colleagues retrospectively reviewed prescribing for medical patients treated at 48 hospitals for pneumonia (6820 patients) or positive urine culture (4928 patients) from December 2015 through September 2017.
The researchers found that 14 of the 48 hospitals reported using pre-prescription approval and/or prospective audit and feedback to target fluoroquinolone prescribing. Fluoroquinolone stewardship was associated with fewer patients receiving a fluoroquinolone (37.1 vs 48.2%) and fewer fluoroquinolone treatment days per 1000 patients (2282 vs 3096), driven by lower inpatient prescribing and after adjustment for other factors. However, 66.6% of fluoroquinolone treatment days occurred after discharge. Hospitals with fluoroquinolone stewardship had twice as many new fluoroquinolone starts after discharge versus hospitals without fluoroquinolone stewardship (15.6 vs 8.4%).
“To limit aggregate fluoroquinolone exposure, stewardship programs should target both inpatient and discharge prescribing,” the authors write.
Blue Cross and Blue Shield of Michigan provided funding for the study.