Optimizing use of ciprofloxacin: a prospective intervention study

Objectives: Antimicrobial resistance to ciprofloxacin is increasing. The objective of this study was to reduce the number of inappropriate prescriptions and to improve the quality of ciprofloxacin prescrip-tions by means of educational intervention. Methods: In a teaching hospital five units of the Departments of Internal Medicine, Gastro-Enterology, Surgery, Urology and Pulmonary Diseases, selected because of a high rate of ciprofloxacin prescrip-tion, participated in a prospective intervention study. The quantity and the quality of prescriptions were reviewed before and after educational intervention and during follow-up. The quality of each ciprofloxacin prescription was independently evaluated by two medical microbiologists. During the intervention period, a medical microbiologist discussed the appropriateness of prescribing ciprofloxa-cin with prescribing clinicians, and educational presentations were given to clinicians of participating units. Regression analysis was used to analyse trends in time-series data. Results: The number of ciprofloxacin prescriptions decreased from 81 prescriptions/1000 admissions before intervention to 32 prescriptions/1000 admissions after intervention, a significant reduction of 60.5%. Appropriate prescriptions significantly increased. Significantly fewer inappropriate prescrip-tions were prescribed after intervention and/or during follow-up. At this time, 23 ciprofloxacin prescrip