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Int J Clin Pharm. 2012 Apr;34(2):325-9. doi: 10.1007/s11096-012-9606-6. Epub 2012 Jan 18.

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

Author information

1
Service d'Hygiène Hospitalière, Centre Hospitalier Universitaire Besançon, 3 Bd Fleming, 25030, Besancon, Cedex, France.

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.

PMID:
22252772
DOI:
10.1007/s11096-012-9606-6
[Indexed for MEDLINE]

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