Fluoroquinolone Restriction Program Reduces Hospital-Acquired C Difficile

Fluoroquinolone Restriction Program Reduces C. Diff
Fluoroquinolone Restriction Program Reduces C. Diff
The program reduced C. difficile infections across 5 different hospitals.

Implementing a health system respiratory fluoroquinolone restriction program in 5 different hospitals reduced the rate of hospital-acquired C difficile infections, according to published research.

Researchers observed a 94% overall reduction in days of respiratory fluoroquinolone therapy and a 35% reduction in hospital-acquired C difficile infections per 1000 patient days.

“Both education and restriction were associated with a significant decrease in moxifloxacin use in the intervention hospitals,” said Katherine Shea, PharmD, clinical director of infectious diseases at Cardinal Health, Innovative Delivery Solutions. Dr. Shea presented results from the retrospective study of 5 hospitals in central Texas at the 2016 ASM Microbe conference.

“This was shown as a reduction of 14.5 days of therapy per month in the education phase and 24.5 in the restriction phase,” she added. “We saw about a 50% reduction in our CDI rate.”

Almost 80% of fluoroquinolone use has been deemed inappropriate in the United States, and fluoroquinolones have also been categorized as high-risk agents for C difficile infections. Prior interventions to limit fluoroquinolone use have caused reductions in C difficile infections, prompting investigators to examine the impact of a health system respiratory fluoroquinolone restriction program on infection rates.

In a multicenter, retrospective study, researchers compared the infection rates of hospital-acquired C difficile at 4 study hospitals ranging from 124 to 534 beds against rates at one 393-bed teaching hospital. The study hospitals implemented a respiratory fluoroquinolone restriction program, which included education, development, and implementation of criteria for utilization.

“When we looked at C difficile infections specifically, in the pre-intervention, education, as well as restriction group, CDI rates did decrease significantly,” Dr. Shea and colleagues noted. “We saw a reduction from about 4 cases per 10,000 patient days to 3.4 in the education phase and 2.2 after restriction.”

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  1. Shea K, Hobbs A, Jaso T, et al. The impact of a respiratory fluoroquinolone restriction program on C. difficile infection rates within a healthcare system. Presented at the American Society for Microbiology Microbe 2016; June 16-20, 2016; Boston, MA.