Fluoroquinolone reduction initiative lowers antibiotic use, resistance

A nonrestrictive fluoroquinolone reduction initiative at an urban teaching hospital has substantially lessened the use of this drug, which is associated with decreased antibiotic resistance in Staphylococcus aureus and Pseudomonas aeruginosa, a study has shown.

This retrospective pre- and postinterventional ecological study was conducted from 2016 to 2017. The fluoroquinolone reduction initiative involved education on risks and alternatives. In addition, buttons with “Save the Quinolones” were worn for more visibility.

The authors then measured the following outcomes: rate of fluoroquinolone use and antibiotic resistance in S. aureus, Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, and P. aeruginosa before and after the intervention.

Throughout the study, use of fluoroquinolones decreased overall, but a significantly higher reduction rate occurred in the postintervention period (monthly decrease, 3.3 percent vs 7.4 percent; p=0.043).

S. aureus susceptibility to oxacillin rose from 47.2 percent to 55.2 percent (difference, 8.0, 95 percent confidence interval [CI], 1.2‒14.7), while P. aeruginosa susceptibility to levofloxacin grew from 60.0 percent to 70.7 percent (difference, 10.7, 95 percent CI, 0.8‒20.6).

Of note, susceptibility rates of E. coli, P. mirabilis, or K. pneumoniae showed no differences.

“Many antibiotic stewardship programs have sought to reduce fluoroquinolone use due to their association with a myriad of negative consequences,” the researchers said.

“In hospital settings with fewer resources, initiatives that are less labour intensive may offer a more feasible approach to addressing fluoroquinolone use and improving patient care,” they added.