Impact of a Fluoroquinolone Restriction Policy in an Elderly Population

Antibiotic use and population ecology: How you can reduce your "resistance footprint"

“…44,54 Such approaches will prove necessary to adequately steward the use of the drugs that we have. As a profession, we would do well to thoroughly engage in discussions and processes in this area as a means of assuring the best interests of our patients while reducing our collective resistance footprint.…”

“…Restriction of fluoroquinolones on the prescription drug formulary for Ontario was not associated with a net change in hospital admissions, and the rate of hospital admissions for gastrointestinal complications was actually decreased. 44 Re-evaluation of patients during the course of an infection to look for improvement or deterioration is an important aspect of medical care as we improve the judicious use of antimicrobials.…”

“…44 • Policy changes in a provincial formulary affected clarithromycin use. 54 • Control of population use was associated with relatively low and stable rates of resistance in pneumococci.…”

Influences on the start, selection and duration of treatment with antibiotics in long-term care facilities

“…12,26 The Ontario Ministry of Health and Long-Term Care provides universal health care coverage for residents of the province, including, but not limited to, physician fees, acute hospital care, long-term care, and drugs for those aged 65 years and over and/or in long-term care facilities. The administrative databases housing these data have been well validated in previous research, 27,28 including extensive studies of antimicrobial use and 29,30 quality of long-term care, 26,31 and confluence of these 2 fields -antimicrobial use in long-term care. 6,12,32 …”

Effect of a Health Care System Respiratory Fluoroquinolone Restriction Program To Alter Utilization and Impact Rates of Clostridium difficile Infection

“…A reduction in fluoroquinolone use may also lead to a reduction in CDI (10)(11)(12). Antimicrobial stewardship strategies have been shown to reduce fluoroquinolone utilization by 30 to 70% (13)(14)(15)(16)(17). Fluoroquinolone restriction can also lead to reduced C. difficile infections, but large-scale studies from the health care system perspective, particularly focused on respiratory fluoroquinolones, are lacking.…”