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Decreasing Clostridium difficile infections by an antimicrobial stewardship program reducing moxifloxacin use.
Antimicrob Agents Chemother. 2014 Jun 16;
Authors: Wenisch JM, Equiluz-Bruck S, Fudel M, Reiter I, Schmid A, Singer E, Chott A
Abstract
OBJECTIVES: Clostridium difficile infections (CDI) in hospitalized patients are known to be closely related to antibiotic exposure. Although several substances can cause CDI, risk differs between individual agents. In Vienna and other eastern parts of Austria, CDI ribotype 027 is currently highly prevalent. This ribotype has the characteristic of intrinsic moxifloxacin resistance. Therefore we hypothesised, that moxifloxacin restriction could decrease CDI cases in hospitalized patients.
METHODS: The antibiotic stewardship (ABS) group applied an information campaign on CDI and formal restriction of moxifloxacin in this 1000- bed tertiary care hospital. The pre-intervention period (period1) was January May and the intervention period June-December 2013 (period2). Defined Daily Doses (DDD) of moxifloxacin and CDI patients/month were recorded.
RESULTS: Moxifloxacin use was reduced from 1038 ± 109 DDD per month (period 1), to monthly 42 ± 10 DDD (period 2) (p= 0.0045). Total antibiotic use was not affected. CDI cases were 59 ± 3 (mean ± SEM) per month in period 1 and 32 ± 3 per month in period 2 (46% reduction, p=0.0044).
CONCLUSION: Reducing moxifloxacin use in combination with structured information on CDI was associated with an immediate decrease in CDI rates in this large community teaching hospital.
PMID: 24936597 [PubMed - as supplied by publisher]