Relevance of fluoroquinolone use in hospitals in the Lorraine region of France before and after corrective measures: An investigation by the Antibiolor network

Abstract

Objectives: This study of fluoroquinolone use was carried out before and after an educational intervention run by Antibiolor, a regional network to all hospitals in the Lorraine region of France. Methods: The relevance of fluoroquinolone prescription according to regional guidelines was assessed using a standard card filled out by physicians and pharmacists at the voluntarily participating hospitals. A therapeutic index of adequacy was established for each card. The initial survey took place in January 2008, with feedback and proposals for corrective measures in January 2009. The second survey was organized in June 2009. The results of the 2 surveys were compared. Results: Twenty-four hospitals completed a total of 1336 cards in the first survey (S1) and 944 cards in the second (S2). The appropriateness of indications for fluoroquinolone use improved by 57% between the 2 surveys. All the criteria analyzed (choice of drug, dosage, treatment duration) were significantly improved in S2 compared to S1, as was the adequacy index (70% improvement). Conclusions: In view of the consequences of fluoroquinolone use, many hospitals in Lorraine were keen to participate in this study, confirming its feasibility over a large area. In view of the study results, the book of guidelines was re-examined and republished at the conclusion of S2. Greater adherence to guidelines was noted in S2, demonstrating the benefit of assessing the situation thoroughly before proposing corrective measures and evaluating their impact.

Keywords::

• Fluoroquinolones
• relevance study
• educational session
• antibiotic good use
• Antibiolor network

Acknowledgements

The authors thank Mrs Christine Barthelemy and Pauline Gerard for their assistance in this study and all the participants of the following hospitals: Centre Jacques Parisot, Bainville sur Madon; Hôpital Saint Joseph, Bitche; Centre Hospitalier Maillot, Briey; Hôpital Saint Jacques, Dieuze; Centre Hospitalier Jean Monnet, Epinal; Centre Hospitalier General Marie-Madeleine, Forbach; Hospitalor, Forbach; Alpha Santé, Hayange; Association Hospitalière, Joeuf; Clinique Jeanne d'Arc, Centre Hospitalier, Luneville; Hôpital St François, Marange-Silvange; Hôpital Bon Secours, Hôpital Saint André, Hôpital Sainte Blandine, Clinique Claude Bernard, Metz; Hôpital du Val du Madon, Mirecourt; Centre Hospitalier et Universitaire, Clinique Ambroise Paré, Polyclinique Gentilly, Nancy; Centre Hospitalier Lemire, Hospitalor, Saint Avold; Centre Hospitalier General, Saint Die des Vosges; Centre Hospitalier St Nicolas, Hôpital de Hoff, Sarrebourg; Hôpital du Parc, Sarreguemines; Centre Hospitalier Saint Charles, Toul; Centre Alexis Vautrin, Vandoeuvre les Nancy; Centre Hospitalier Saint Nicolas, Verdun; Centre Hospitalier, Vittel; Centre Hospitalier, Chaumont.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.