A simple intervention to reduce inappropriate ciprofloxacin prescribing in the emergency department.

Abstract

BACKGROUND:

According to Norwegian guidelines for antibiotic use in primary care, ciprofloxacin is reserved for complicated urinary tract infections (UTI). Despite these recommendations, ciprofloxacin use has increased in Norway in recent years. We aimed to reduce inappropriate ciprofloxacin prescribing in the emergency department.

METHODS:

An intervention study was performed by removing ciprofloxacin from the local antibiotic formulary and including a suggestion list for antibiotic use with all point of care urine dipstick testing in an emergency department. An emergency department in the neighbouring county served as the control. Prescriptions for UTI were registered 1 y prior to and 1 y after the intervention.

RESULTS:

In the targeted emergency department, there was a significant (p < 0.0001) reduction in ciprofloxacin prescribing for cystitis, while the use of mecillinam increased (p = 0.042). In the control department, prescribing of ciprofloxacin doubled (p < 0.0001).

CONCLUSIONS:

An intervention based on a therapy suggestion list and on limiting the availability of ciprofloxacin in the local formulary, resulted in treatment more in line with national guidelines by reducing ciprofloxacin and increasing mecillinam prescribing.

• Authors: Mark Fagan, Morten Lindbæk, Harald Reiso, Dag Berild
• Journal: Scandinavian journal of infectious diseases (Scand J Infect Dis) Vol. 46 Issue 7 Pg. 481-5 (Jul 2014) ISSN: 1651-1980 [Electronic] England
• PMID: 24552583 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Ciprofloxacin
• Amdinocillin

Topics

• Amdinocillin (therapeutic use)
• Anti-Bacterial Agents (therapeutic use)
• Ciprofloxacin (therapeutic use)
• Cystitis (drug therapy, microbiology)
• Emergency Service, Hospital
• Female
• Humans
• Inappropriate Prescribing (prevention & control)
• Male
• Norway
• Practice Guidelines as Topic
• Pyelonephritis (drug therapy, microbiology)
• Urinary Tract Infections (drug therapy)