1. Impact of a region wide antimicrobial stewardship guideline on urinary tract infection prescription patterns
- Author
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Danièle Sekri, Xavier Bertrand, C. Slekovec, Nathalie Vernaz-Hegi, Bruno Hoen, Daniel Talon, J. Leroy, Jean-Pierre Faller, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Hôpital Jean Minjoz, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), and Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques
- Subjects
Health Knowledge, Attitudes, Practice ,Antibiotics ,MESH : Drug Prescriptions ,MESH: Health Knowledge, Attitudes, Practice ,MESH : Aged ,MESH: Urinary Tract Infections ,Toxicology ,MESH: Regression Analysis ,MESH : General Practitioners ,MESH : Guideline Adherence ,0302 clinical medicine ,MESH : Physician's Practice Patterns ,Anti-Infective Agents ,MESH : Regression Analysis ,Medicine ,Pharmacology (medical) ,MESH : Urinary Tract Infections ,Practice Patterns, Physicians' ,MESH: Drug Utilization ,0303 health sciences ,MESH: Program Evaluation ,MESH : Education, Medical, Continuing ,MESH: Middle Aged ,3. Good health ,MESH : Practice Guidelines as Topic ,[SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology ,MESH: Young Adult ,MESH: Guideline Adherence ,MESH : Anti-Infective Agents ,Regression Analysis ,Education, Medical, Continuing ,Guideline Adherence ,medicine.medical_specialty ,MESH : Fosfomycin ,Attitude of Health Personnel ,Urinary system ,MESH: Attitude of Health Personnel ,MESH : Young Adult ,Pharmacy ,Drug Prescriptions ,03 medical and health sciences ,MESH : Adolescent ,[ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology ,Humans ,MESH : Middle Aged ,MESH : Norfloxacin ,MESH: Physician's Practice Patterns ,Norfloxacin ,Aged ,Pharmacology ,MESH: Adolescent ,MESH: Humans ,030306 microbiology ,MESH : Humans ,MESH: Adult ,Guideline ,MESH: Education, Medical, Continuing ,Nitrofurantoin ,MESH: Female ,MESH : Attitude of Health Personnel ,Pediatrics ,Time Factors ,MESH : Health Knowledge, Attitudes, Practice ,Pharmaceutical Science ,MESH : Drug Utilization ,MESH: Fosfomycin ,MESH: Practice Guidelines as Topic ,MESH: Drug Prescriptions ,[ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology ,Antimicrobial stewardship ,MESH : Female ,030212 general & internal medicine ,MESH: Aged ,MESH : Adult ,Middle Aged ,MESH: General Practitioners ,MESH : Program Evaluation ,Practice Guidelines as Topic ,Urinary Tract Infections ,MESH: Nitrofurantoin ,Female ,France ,medicine.drug ,MESH : Time Factors ,Adult ,MESH: Norfloxacin ,Adolescent ,medicine.drug_class ,MESH: Anti-Infective Agents ,Young Adult ,Fosfomycin ,General Practitioners ,Internal medicine ,MESH : Nitrofurantoin ,Medical prescription ,MESH : France ,business.industry ,MESH: Time Factors ,Drug Utilization ,MESH: France ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Program Evaluation - Abstract
International audience; 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.
- Published
- 2012