Category: Federal Forum Posters
Purpose: In May 2016, the FDA recommended restricting fluoroquinolone antibiotics for use in acute bronchitis, acute bacterial rhinosinusitis (ABRS) and acute cystitis as the side effect profile of fluoroquinolones often outweighs the benefits of treatment. Additionally, fluoroquinolones are frequently prescribed for acute chronic obstructive pulmonary disease (COPD) exacerbations. The primary objective of this study was to evaluate the pharmacist audit and feedback impact on the number of inappropriately prescribed fluoroquinolones for the above indications.
Methods: A retrospective chart review was conducted on 109 patients who received a fluoroquinolone antibiotic for the treatment of acute bronchitis (n equals 9), COPD exacerbation (n equals 32), ABRS (n equals 18) and acute cystitis (n equals 10) from October to December 2016 in our Veterans Affairs outpatient clinics. Data analyzed for appropriate use of fluoroquinolones found 57.8 percent (n equals 63) prescriptions were inappropriate. Additional education was presented to providers regarding fluoroquinolones and prescribing guidance cards were distributed. A retrospective chart review from January to March 2018 was conducted to evaluate the impact provider education and prescribing guidance cards had on inappropriate fluoroquinolone prescriptions. The overall use of fluoroquinolones decreased (n equals 84), but the number of inappropriate prescriptions (60 percent) was unchanged. Education alone was not effective to change prescribing patterns. A pharmacy audit and feedback was implemented in May 2018 requiring providers to include an indication on all fluoroquinolone prescriptions. The pharmacist assessed the appropriateness of the prescription, provided recommendations when appropriate and documented the intervention in the electronic medical chart. A retrospective chart review will be completed from July to September 2018 evaluating the pharmacist-driven audit and feedback and its impact on appropriateness of fluoroquinolone prescribing.
Results: not applicable
Conclusion: not applicable
Andrew Sankey– Pharmacist, Veterans Affairs, Omaha, NE