459. Impact of Antibiotics Stewardship Program on Appropriateness of Fluoroquinolone Use at a Community Hospital
Session: Poster Session: Hospital-acquired and Transplant Infections
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
Introduction: Inappropriate use of antibiotics adversely affects the quality of medical care. This study’s goal was to reduce inappropriate prescription of the fluoroquinolones ciprofloxacin and moxifloxacin, by implementing a multidisciplinary antibiotics stewardship program.
Methods: The project was a quality assurance retrospective and prospective interventional study divided into three phases: pre-interventional; interventional and educational program; and post-interventional. Use of fluoroquinolones was observed and documented, including number of days and primary diagnosis. Crosschecking determined whether proper culture and sensitivity tests were done. If an improper workup was noted, the caregiver was telephoned and a proper workup was requested. During the education phase, weekly departmental meetings reinforced the appropriate use of targeted antibiotics, along with literature and flyers. The post-interventional phase documented the effect of the educational program. Statistical analysis was done using the chi square test.
Results: 873 patients were included for all three phases of the study. The mean duration for which an antibiotic was given was 6 days. 52% used ciprofloxacin; 40%, moxifloxacin; and the remaining 8% were either on multiple antibiotics or excluded. 67% of patients had proper culture and sensitivity done during phase 1, compared to 68% in phase 2, and 79% in phase 3 (p=0.003). 10% of patients were on the correct antibiotics in phase 1, compared to 15% in phase 2, and 40% in phase 3 (p<0.001). Rate of follow-up comparison of patient culture results with the type of antibiotic increased from 15% in phase 1 to 42% in phase 3.
Conclusion: The stewardship program successfully increased the rate of proper antibiotics given, proper culture and sensitivity tests done, and the patient follow-up comparison.
Kalil Al-Nassir, MD1, Kell Julliard, MA1, Rama Krishna Mukkara Siva, MD1, Afaf Pouls, MD1, Nadeem Shahid, MD1, Rohit Sharma, MD2, Surinder Singh, MD1, Taleb Taha, MD1, David Tompkins, MD1, Ernest Visconti, MD1 and  R. Sharma, None..
K. Al-Nassir, None..
A. Pouls, None..
N. Shahid, None..
S. P. Singh, None..
R. Mukkara Siva, None..
T. taha, None..
D. Tompkins, None..
K. Julliard, None..
E. Visconti, None., (1)Lutheran Medical Center, Brooklyn, NY, (2)Clinical Research, Lutheran Medical Center, Brooklyn, NY