[Proper use of fluoroquinolones in hospitalized elderly patients: Realisation of a clinical audit in geriatric hospitals of Lyon University Hospital]

Rev Med Interne. 2018 Jul;39(7):551-556. doi: 10.1016/j.revmed.2018.03.002. Epub 2018 May 18.
[Article in French]

Abstract

Introduction: Fluoroquinolones (FQ) are widely used because of their broad spectrum and their ease of use, especially in the elderly. Nevertheless, their misuse is behind the development and the emergence of bacterial resistances. The objective of this study was to evaluate the compliance of FQ prescriptions in the elderly hospitalized, before and after pharmaceutical interventions (PI).

Methods: A prospective clinical audit was conducted for three months in three geriatric hospitals. A pharmacist carried out the evaluation of the prescription's conformity with the help of referent geriatric doctor in infectiology according to the criteria defined by SPILF recommendations (2015). The PIs and their future have been collected and codified.

Results: A total of 100 patients were included (mean age: 85.3 years; male female ratio: 1,17). The medical-pharmaceutical collaboration helped to increase the overall compliance rate from 56 to 80%. FQ were used for urinary (72%) or respiratory (20%) infections, first-line (57%), documented (60%) and monotherapy (63%). Our results show that FQ misuse is a not inconsiderable case since in 28% they should not have been prescribed. Thirty-three PI were performed and accepted in 72% cases.

Conclusion: Actions to promote the FQ proper use have therefore been put in place: communication of the audit results, dissemination of a summary of SPILF recommendations and creation of a tool to assist in the analysis of prescriptions FQ for pharmacists.

Keywords: Audit clinique; Bon usage; Clinical audit; Elderly patient; Fluoroquinolones; Proper use; Sujet âgé.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Clinical Audit
  • Female
  • Fluoroquinolones / therapeutic use*
  • France / epidemiology
  • Health Services for the Aged / standards
  • Health Services for the Aged / statistics & numerical data*
  • Hospices / statistics & numerical data
  • Hospitalization / statistics & numerical data*
  • Hospitals, University / statistics & numerical data
  • Humans
  • Male
  • Practice Patterns, Physicians' / standards
  • Practice Patterns, Physicians' / statistics & numerical data*

Substances

  • Fluoroquinolones