MMSL 2020, 89(4):178-189 | DOI: 10.31482/mmsl.2020.014

EFFECTS OF FLUOROQUINOLONE RESTRICTION IN THE HOSPITAL ON THE DEVELOPMENT OF SENSITIVITY OF SELECTED BACTERIAL PATHOGENSOriginal article

Pavla Paterova ORCID...1*, Lenka Ryskova ORCID...1, Miroslav Fajfr ORCID...1, Katerina Kuncova ORCID...1, Katerina Neradova ORCID...1, Kristyna Vaverkova1, Lenka Hobzova2, Petr Prasil ORCID...3, Stanislav Plisek ORCID...3, Jakub Radocha ORCID...4, Pavel Bostik ORCID...1, Helena Zemlickova ORCID...1,5
1 Department of Clinical Microbiology, University Hospital and Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
2 Department of Hospital Hygiene, University Hospital, Hradec Kralove, Czech Republic
3 Department of Infectious Diseases, University Hospital and Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
4 4th Department of Internal Medicine – Hematology, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic
5 Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic

Introduction: Fluoroquinolones are a frequently prescribed class of antibiotics, which has been blacklisted in recent years because of a growing evidence of the connection with serious undesirable effects, infections Clostridioides difficile, and a connection with the occurrence of multiresistant strains.

Methods: In the University Hospital Hradec Kralove in the course of the years 2009-2019, several antibiotic stewardship restrictive and educational interventions were performed by the Antibiotic Centre aiming to decrease quinolone antibiotics administration. The data of the consumption of quinolone antibiotics were retrospectively evaluated and correlated with the development of sensitivity and occurrence of multiresistance of selected bacteria in the hospital.

Results: In the period under investigation, consumption of fluoroquinolone antibiotics significantly decreased (p<0.001) in 10 years by 71.8% to 26.7 DDD/1000 patient day. Sensitivity of Escherichia coli and Pseudomonas aeruginosa to fluoroquinolones in the period under investigation increased by 4.8% (respectively by 15%); on the other hand, sensitivity of Staphylococcus aureus decreased by 4.2% to 85.5% share of sensitive strains. The incidence of the multiresistant isolates Pseudomonas aeruginosa decreased by 8.1%, but the occurrence of ESBL-producing Klebsiella pneumoniae was increased in the period under investigation. The occurrence of methicillin-resistant Staphylococcus aureus did not show a stable trend and finally it was moderately increased by 2.9%.

Conclusion: Implementation of programmes of antimicrobial stewardship for hospitalized patients resulted in a decrease and a rationalization of fluoroquinolone administration. The reduction of their consumption in our hospital resulted in a statistically insignificant increase in the sensitivity of Escherichia coli and Pseudomonas aeruginosa, but not Staphylococcus aureus.

Keywords: antibiotic consumption; antimicrobial stewardship; bacterial pathogen; fluoroquinolone; sensitivity

Received: May 26, 2020; Revised: June 30, 2020; Accepted: July 1, 2020; Prepublished online: July 16, 2020; Published: December 4, 2020  Show citation

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Paterova, P., Ryskova, L., Fajfr, M., Kuncova, K., Neradova, K., Vaverkova, K., ... Zemlickova, H. (2020). EFFECTS OF FLUOROQUINOLONE RESTRICTION IN THE HOSPITAL ON THE DEVELOPMENT OF SENSITIVITY OF SELECTED BACTERIAL PATHOGENS. MMSL, 89(4), 178-189. doi: 10.31482/mmsl.2020.014
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