International Journal of Clinical Pharmacy

, Volume 34, Issue 2, pp 325–329 | Cite as

Impact of a region wide antimicrobial stewardship guideline on urinary tract infection prescription patterns

  • Celine Slekovec
  • Joël Leroy
  • Nathalie Vernaz-Hegi
  • Jean-Pierre Faller
  • Danièle Sekri
  • Bruno Hoen
  • Daniel Talon
  • Xavier BertrandEmail author
Research Article


Background Fluoroquinolones are frequently prescribed for non complicated urinary tract infection treatments and have a negative ecological impact. We aimed to substitute them by antibiotics with narrower activity spectrum in order to preserve fluoroquinolone activity in complicated hospital infections. Objective To assess the impact of a multi-modal approach that combines the dispatching of antibiotic prescription guidelines and voluntary attendance at educational sessions on general practitioners’ (GP) antibiotic prescription habits. Setting This study was led in Franche-Comté, a French eastern region, where GPs were given a guideline recommending a restricted use of fluoroquinolones for urinary tract infections. Method Segmented regression analysis of interrupted time series was used to assess changes in antibiotic prescription. Main outcome measure: The antibiotic prescription data of nitrofurantoin, fosfomycin-trometamol and fluoroquinolones for women aged 15–65 years were obtained from the regional agency of health insurance. Results Twenty months after intervention, the number of nitrofurantoin and fosfomycintrometamol prescriptions increased by 36.8% (95% CI: 30.6–42.2) and 28.5% (95% CI: 22.9–35.4), respectively, while that of norfloxacin decreased by 9.1% (95% CI: −15.3 to −3.5). Conclusion This study suggests that the dispatch of the guideline on urinary tract infection had a moderate impact on antibiotic prescriptions.


Antibiotic Antibiotic stewardship France Prescription Regional guideline Segmented regression Urinary tract infection 



We thank all the GPs of Franche-Comte, who enabled the use of their prescription data.


No specific funding.

Conflicts of interest



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Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Celine Slekovec
    • 1
    • 2
  • Joël Leroy
    • 2
    • 3
  • Nathalie Vernaz-Hegi
    • 4
  • Jean-Pierre Faller
    • 5
  • Danièle Sekri
    • 6
  • Bruno Hoen
    • 2
    • 3
  • Daniel Talon
    • 1
    • 2
  • Xavier Bertrand
    • 1
    • 2
    Email author
  1. 1.Service d’Hygiène HospitalièreCentre Hospitalier Universitaire BesançonBesanconFrance
  2. 2.UMR 6249 Chrono-environnementUniversité de Franche-ComtéBesanconFrance
  3. 3.Service de Maladies InfectieusesCentre Hospitalier Universitaire BesançonBesanconFrance
  4. 4.Hôpitaux Universitaires de GenèveGenevaSwitzerland
  5. 5.Service de Maladies Infectieuses et RéanimationCentre Hospitalier de Belfort-MonbéliardMonbeliardFrance
  6. 6.Agence Régionale de la SantéBesanconFrance

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