Title of the publicationHospital-wide modification of fluoroquinolone policy and meticillin-resistant Staphylococcus aureus rates: a 10-year interrupted time-series analysis
Abstract

In our tertiary university hospital, fluoroquinolones were prohibited during 2001 leading to a 90% reduction in their use. Our objective was to examine the trends in meticillin-resistant Staphylococcus aureus (MRSA) following the reintroduction of fluoroquinolones. We conducted a 10-year time-series analysis of monthly MRSA according to: (i) period of fluoroquinolone restriction (January 2001 to January 2002); (ii) period of fluoroquinolone increase up to pre-restriction levels (January 2002 to December 2004); and (iii) an observational period including the implementation of a hand hygiene campaign with alcohol-based hand rub (January 2005 to June 2009). We used segmented linear autoregression analysis to assess trends between adjacent periods. Fluoroquinolone use increased from 5.2 defined daily doses (DDD) per 1000 patient-days in 2001 to 56.6 DDD per 1000 patient-days in 2005 reaching pre-restriction fluoroquinolone levels (P<0.001) and remained stable during 2005e2010 (P=0.65). The monthly proportion of MRSA decreased during the period of FQ restriction (-0.49 per month, P < 0.05). The reintroduction of fluoroquinolones was associated with a significant increase in MRSA (+0.68 per month, P<0.02) compared to the previous period. During period 3, we observed a significant change in MRSA (-5.9, P<0.002) compared to the previous period (-0.32 per month, P<0.001). During the latter period, hand hygiene was promoted and alcohol-based hand-rub consumption increased from 3411 L in 2005 to 14 599 L in 2009. This study reinforces the rationale for a hospital-wide fluoroquinolone formulary policy to control MRSA and suggests that it has an additive effect with a hand hygiene promotion.

DOIhttps://doi.org/10.1016/j.jhin.2011.03.008
Name of the first authorParienti, J.-J.
Year of publication2011
Study design of the publicationTime-series analysis
Method for data collection and analysis
  • Qualitative data - Qualitative data were used during the intervention
Qualitative data - Qualitative data were used during the intervention
Scientific references about the intervention or other assessment of the intervention

5. Charbonneau P, Parienti JJ, Thibon P, et al. Fluoroquinolone use and methicillin-resistant Staphylococcus aureus isolation rates in hospitalized patients: a quasi experimental study. Clin Infect Dis 2006;42:778e784.

Sector
  • Human - All activities regarding organisations and individuals involved in health products and services
Sub-sectorSub-sectors are further units of demarcation within a sector E.g. awareness campaign from veterinarians to cat owners about toxoplasmosis drug resistance and transmission of resistant bacteria: ANIMAL, PETS
Subsector (human)
  • Healthcare delivery
Healthcare delivery