{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T13:31:34Z","timestamp":1777901494544,"version":"3.51.4"},"reference-count":10,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Science Progress"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:p>This study evaluated an antibiotic stewardship program (ASP) intervention aimed at reducing inpatient fluoroquinolone (FQ) use and examined its impact on ciprofloxacin susceptibilities of gram-negative bacteria in a large 611-bed community hospital. A two-step ASP intervention was implemented: an electronic medical record algorithm that prompted physicians to re-evaluate FQ use shortly after admission and changed institutional UTI\/pneumonia guidelines that recommended options alternate to FQs for first-line empiric antibiotic therapy in 2010 and 2011 respectively. Between 2007 and 2017 FQ use and ciprofloxacin susceptibilities of all non-duplicate cultured isolates of Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas aeruginosa obtained \u226572\u2009h after admission were reviewed. Ambulatory care isolates served as a comparison group. FQ utilization rates and relationships to ciprofloxacin susceptibility were evaluated using interrupted time series models. Over the 11-year period, FQ use decreased from 110.0 (2007) to 26.2 (2017) days of therapy\/1000\u2009days at risk ( p\u2009&lt;\u20090.001). Compared to pre-intervention, the estimated (post-intervention) reduction in FQ utilization was 28.4 (95% CI: 10.9\u201346) days of therapy\/1000\u2009days at risk. Reduced FQ utilization was correlated with increase susceptibilities to ciprofloxacin of hospital onset isolates of Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis ( p\u2009&lt;\u20090.02), and Pseudomonas aeruginosa ( p\u2009=\u20090.07). No significant susceptibility change was observed in the ambulatory care isolates. Persuasive interventions by an ASP successfully modified physicians\u2019 inpatient empiric antibiotic use, produced a sustained reduction in FQ utilization rates and increased ciprofloxacin susceptibility to four commonly encountered gram-negative bacteria in a community hospital.<\/jats:p>","DOI":"10.1177\/00368504211011876","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T06:43:44Z","timestamp":1619592224000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Association between fluoroquinolone utilization rates and susceptibilities of gram-negative bacilli: Results from an 8-year intervention by an antibiotic stewardship program in an inner-city United States hospital"],"prefix":"10.1177","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8922-7150","authenticated-orcid":false,"given":"Cosmina","family":"Zeana","sequence":"first","affiliation":[{"name":"Division of Adult Infectious Disease, Department of Medicine, BronxCare Health System, Bronx, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank E.","family":"Palmieri","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, BronxCare Health System, Bronx, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikas","family":"Gupta","sequence":"additional","affiliation":[{"name":"Becton, Dickinson and Company, Franklin Lakes, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Ye","sequence":"additional","affiliation":[{"name":"Becton, Dickinson and Company, Franklin Lakes, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Lao","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, BronxCare Health System, Bronx, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalvin","family":"Yu","sequence":"additional","affiliation":[{"name":"Becton, Dickinson and Company, Franklin Lakes, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyoung-Sil","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, BronxCare Health System, Bronx, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larry","family":"Schiller","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, BronxCare Health System, Bronx, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murli","family":"Purswani","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious disease, Department of Pediatrics, BronxCare Health System, Bronx, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,4,28]]},"reference":[{"key":"bibr1-00368504211011876","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0b013e32832d52e0"},{"key":"bibr2-00368504211011876","doi-asserted-by":"publisher","DOI":"10.1086\/510393"},{"key":"bibr3-00368504211011876","doi-asserted-by":"publisher","DOI":"10.1086\/379709"},{"key":"bibr4-00368504211011876","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00856-08"},{"key":"bibr5-00368504211011876","doi-asserted-by":"publisher","DOI":"10.1086\/382690"},{"key":"bibr6-00368504211011876","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2018.245"},{"key":"bibr7-00368504211011876","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00950-16"},{"key":"bibr8-00368504211011876","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkw055"},{"key":"bibr9-00368504211011876","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.14.1270"},{"issue":"5","key":"bibr10-00368504211011876","doi-asserted-by":"crossref","DOI":"10.1093\/cid\/ciu360","volume":"64","author":"Tamma PD","year":"2017","journal-title":"Clin Infect Dis"}],"container-title":["Science 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