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Fluoroquinolone resistance during 2000-2005: an observational study.

Publication ,  Journal Article
Ryan, RJ; Lindsell, C; Sheehan, P
Published in: BMC Infect Dis
May 24, 2008

BACKGROUND: Moxifloxacin is a respiratory fluoroquinolone with a community acquired pneumonia indication. Unlike other fluoroquinolones used in our healthcare system, moxifloxacin's urinary excretion is low and thus we hypothesized that increased use of moxifloxacin is associated with an increase in fluoroquinolone resistance amongst gram negative uropathogens. METHODS: All antibiograms for Gram negative bacteria were obtained for 2000 to 2005. The defined daily dose (DDD) for each fluoroquinolone was computed according to World Health Organization criteria. To account for fluctuation in patient volume, DDD/1000 bed days was computed for each year of study. Association between DDD/1000 bed days for each fluoroquinolone and the susceptibility of Gram negative bacteria to ciprofloxacin was assessed using Pearson's Correlation Coefficient, r. RESULTS: During the study period, there were 48,261 antibiograms, 347,931 DDD of fluoroquinolones, and 1,943,338 bed days. Use of fluoroquinolones among inpatients decreased from 237.2 DDD/1000 bed days in 2000 to 115.2 DDD/1000 bed days in 2005. With the exception of Enterobacter aerogenes, moxifloxacin use was negatively correlated with sensitivity among all 13 Gram negative species evaluated (r = -0.07 to -0.97). When the sensitivities of all Gram negative organisms were aggregated, all fluoroquinolones except moxifloxacin were associated with increased sensitivity (r = 0.486 to 1.000) while moxifloxacin was associated with decreased sensitivity (r = -0.464). CONCLUSION: Moxifloxacin, while indicated for empiric treatment of community acquired pneumonia, may have important negative influence on local antibiotic sensitivities amongst Gram negative organisms. This effect was not shared by other commonly used members of the fluoroquinolone class.

Duke Scholars

Published In

BMC Infect Dis

DOI

EISSN

1471-2334

Publication Date

May 24, 2008

Volume

8

Start / End Page

71

Location

England

Related Subject Headings

  • Quinolines
  • Pneumonia, Bacterial
  • Pharmacy Service, Hospital
  • Moxifloxacin
  • Microbiology
  • Microbial Sensitivity Tests
  • Humans
  • Gram-Negative Bacterial Infections
  • Gram-Negative Bacteria
  • Fluoroquinolones
 

Citation

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Ryan, R. J., Lindsell, C., & Sheehan, P. (2008). Fluoroquinolone resistance during 2000-2005: an observational study. BMC Infect Dis, 8, 71. https://doi.org/10.1186/1471-2334-8-71
Ryan, Richard J., Chris Lindsell, and Paul Sheehan. “Fluoroquinolone resistance during 2000-2005: an observational study.BMC Infect Dis 8 (May 24, 2008): 71. https://doi.org/10.1186/1471-2334-8-71.
Ryan RJ, Lindsell C, Sheehan P. Fluoroquinolone resistance during 2000-2005: an observational study. BMC Infect Dis. 2008 May 24;8:71.
Ryan, Richard J., et al. “Fluoroquinolone resistance during 2000-2005: an observational study.BMC Infect Dis, vol. 8, May 2008, p. 71. Pubmed, doi:10.1186/1471-2334-8-71.
Ryan RJ, Lindsell C, Sheehan P. Fluoroquinolone resistance during 2000-2005: an observational study. BMC Infect Dis. 2008 May 24;8:71.
Journal cover image

Published In

BMC Infect Dis

DOI

EISSN

1471-2334

Publication Date

May 24, 2008

Volume

8

Start / End Page

71

Location

England

Related Subject Headings

  • Quinolines
  • Pneumonia, Bacterial
  • Pharmacy Service, Hospital
  • Moxifloxacin
  • Microbiology
  • Microbial Sensitivity Tests
  • Humans
  • Gram-Negative Bacterial Infections
  • Gram-Negative Bacteria
  • Fluoroquinolones