1447. Implementation of Strategies to Impact Quinolone Use: Results from a 7.5 year Evaluation from an Inner City Hospital
Session: Poster Abstract Session: Antimicrobial Stewardship: Interventions
Saturday, October 10, 2015
Room: Poster Hall
  • IDSA abxuse Poster2 v6.pdf (579.6 kB)
  • Background:   The CDC estimates that 30 to 50% of antibiotic usage in hospitals is unnecessary or inappropriate.  The high fluoroquinolone use identified at Bronx Grand Concourse prompted a multifaceted intervention to reduce fluoroquinolone use.

    Methods: Fluoroquinolone (FQ), 3rd/4th generation cephalosporin (3/4 Ceph), piperacillin/tazobactam (P-T), and carbapenem (CB) use, measured as days of therapy [DOT] per 1000 days at risk [DAR]) was obtained from MedMined Surveillance Advisor (CareFusion-BD, San Diego, CA) from July-December 2007 and yearly through 2014.  The institution implemented the following FQ control strategies: (a) intravenous (IV) to oral (PO) transition with hard stop between 2010-2011, (b) UTI/pneumonia guidelines 2011-2012 and (c) analysis of antimicrobial susceptibility to combination of antibiotics 2011-2012.  Pearson correlation coefficient was used to assess the significance in antimicrobial changes.

    Results:  Over the 7.5 year period, fluoroquinolone use decreased significantly from 111.5 (July-Dec 2007) to 43.6 (2014) DOT/1000 DAR (-0.98, p < 0.0001).  During that time there was a significant increase in use of 3/4 Ceph (69 to 90.7 [0.83, p < 0.001]), P-T (76.1 to 99 [0.84, p < 0.0001]), and CB (18.4 to 23.6 [0.85, p < 0.0001]).  However, combined FQ, 3/4 Ceph, P-T, and CB use was significantly lower during the study period (274.9 to 256.8 [-0.91, p < 0.0001]).

    Conclusion: Multifaceted strategies to impact quinolone use at an inner city hospital resulted in a significant decrease in quinolone use and an associated decrease in broad-spectrum antimicrobial use. Such strategies can impact related antimicrobial resistance.


    Frank Palmieri, PhD, RPh1, Vikas Gupta, Pharm.D., BCPS2, Xiaowu Sun, PhD3, Peter Lao, MS RPh4, Kyoung-Sil Kang, PharmD, BCPS5, Larry Schiller, RPh4 and Cosmina Zeana, M.D.6, (1)Pharmacy, Bronx Lebanon Hospital Center, Bronx, NY, (2)CareFusion, MedMined Services, Birmingham, AL, (3)Clinical Research, CareFusion - BD, San Diego, CA, (4)Bronx Lebanon Hospital Center, Bronx, NY, (5)Pharmacy, Bronx Lebenon Hospital center, Bronx, NY, (6)Infectious Disease, Bronx-Lebanon Hospital Center, Bronx, NY


    F. Palmieri, None

    V. Gupta, None

    X. Sun, None

    P. Lao, None

    K. S. Kang, None

    L. Schiller, None

    C. Zeana, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.