Impact of a region wide antimicrobial stewardship guideline on urinary tract infection prescription patterns.

Abstract

BACKGROUND:

Fluoroquinolones are frequently prescribed for non complicated urinary tract infection treatments and have a negative ecological impact. We aimed to substitute them by antibiotics with narrower activity spectrum in order to preserve fluoroquinolone activity in complicated hospital infections.

OBJECTIVE:

To assess the impact of a multi-modal approach that combines the dispatching of antibiotic prescription guidelines and voluntary attendance at educational sessions on general practitioners' (GP) antibiotic prescription habits.

SETTING:

This study was led in Franche-Comté, a French eastern region, where GPs were given a guideline recommending a restricted use of fluoroquinolones for urinary tract infections.

METHOD:

Segmented regression analysis of interrupted time series was used to assess changes in antibiotic prescription.

MAIN OUTCOME MEASURE:

The antibiotic prescription data of nitrofurantoin, fosfomycin-trometamol and fluoroquinolones for women aged 15-65 years were obtained from the regional agency of health insurance.

RESULTS:

Twenty months after intervention, the number of nitrofurantoin and fosfomycintrometamol prescriptions increased by 36.8% (95% CI: 30.6-42.2) and 28.5% (95% CI: 22.9-35.4), respectively, while that of norfloxacin decreased by 9.1% (95% CI: -15.3 to -3.5).

CONCLUSION:

This study suggests that the dispatch of the guideline on urinary tract infection had a moderate impact on antibiotic prescriptions.

• Authors: Celine Slekovec, Joël Leroy, Nathalie Vernaz-Hegi, Jean-Pierre Faller, Danièle Sekri, Bruno Hoen, Daniel Talon, Xavier Bertrand
• Journal: International journal of clinical pharmacy (Int J Clin Pharm) Vol. 34 Issue 2 Pg. 325-9 (Apr 2012) ISSN: 2210-7711 [Electronic] Netherlands
• PMID: 22252772 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Anti-Infective Agents
• Fosfomycin
• Nitrofurantoin
• Norfloxacin

Topics

• Adolescent
• Adult
• Aged
• Anti-Infective Agents (therapeutic use)
• Attitude of Health Personnel
• Drug Prescriptions (standards)
• Drug Utilization (standards)
• Education, Medical, Continuing
• Female
• Fosfomycin (therapeutic use)
• France
• General Practitioners (education, standards)
• Guideline Adherence
• Health Knowledge, Attitudes, Practice
• Humans
• Middle Aged
• Nitrofurantoin (therapeutic use)
• Norfloxacin (therapeutic use)
• Practice Guidelines as Topic
• Practice Patterns, Physicians' (standards)
• Program Evaluation
• Regression Analysis
• Time Factors
• Urinary Tract Infections (drug therapy)
• Young Adult