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

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Abstract

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.

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Acknowledgments

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

Funding

No specific funding.

Conflicts of interest

None.

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Authors and Affiliations

  1. Service d’Hygiène Hospitalière, Centre Hospitalier Universitaire Besançon, 3 Bd Fleming, 25030, Besancon, Cedex, France

    Celine Slekovec, Daniel Talon & Xavier Bertrand

  2. UMR 6249 Chrono-environnement, Université de Franche-Comté, Besancon, France

    Celine Slekovec, Joël Leroy, Bruno Hoen, Daniel Talon & Xavier Bertrand

  3. Service de Maladies Infectieuses, Centre Hospitalier Universitaire Besançon, Besancon, France

    Joël Leroy & Bruno Hoen

  4. Hôpitaux Universitaires de Genève, Geneva, Switzerland

    Nathalie Vernaz-Hegi

  5. Service de Maladies Infectieuses et Réanimation, Centre Hospitalier de Belfort-Monbéliard, Monbeliard, France

    Jean-Pierre Faller

  6. Agence Régionale de la Santé, Besancon, France

    Danièle Sekri

Authors
  1. Celine Slekovec
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  2. Joël Leroy
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  3. Nathalie Vernaz-Hegi
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  4. Jean-Pierre Faller
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  5. Danièle Sekri
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  6. Bruno Hoen
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  7. Daniel Talon
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  8. Xavier Bertrand
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Corresponding author

Correspondence to Xavier Bertrand.

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Slekovec, C., Leroy, J., Vernaz-Hegi, N. et al. Impact of a region wide antimicrobial stewardship guideline on urinary tract infection prescription patterns. Int J Clin Pharm 34, 325–329 (2012). https://doi.org/10.1007/s11096-012-9606-6

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  • DOI: https://doi.org/10.1007/s11096-012-9606-6

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