Clostridium difficile Infection Rates Reduced at a Health Care System after Restriction of Respiratory Fluoroquinolones

Fluoroquinolones are one of the most commonly prescribed antibiotic classes in the United States and up to 81% of inpatient utilization has been deemed inappropriate. Our study, recently published in Antimicrobial Agents of Chemotherapy, aimed to determine the impact of respiratory fluoroquinolone education and restriction on utilization, appropriateness of quinolone-based therapy, and CDI rates within a health care system. Both phases of implementation were successful at significantly reducing respiratory fluoroquinolone utilization as well as CDI rates. Utilization was reduced by 48% after clinician education and 88% following implementation of restriction criteria. Mean monthly CDI cases also decreased by approximately 50% from pre-intervention to post-restriction.