{"doi":"10.1017/ash.2021.197","title":"Reductions in inpatient fluoroquinolone use and postdischarge <i>Clostridioides difficile</i> infection (CDI) from a systemwide antimicrobial stewardship intervention","abstract":"Abstract Objective: To determine the impact of an inpatient stewardship intervention targeting fluoroquinolone use on inpatient and postdischarge Clostridioides difficile infection (CDI). Design: We used an interrupted time series study design to evaluate the rate of hospital-onset CDI (HO-CDI), postdischarge CDI (PD-CDI) within 12 weeks, and inpatient fluoroquinolone use from 2 years prior to 1 year after a stewardship intervention. Setting: An academic healthcare system with 4 hospitals. Patients: All inpatients hospitalized between January 2017 and September 2020, excluding those discharged from locations caring for oncology, bone marrow transplant, or solid-organ transplant patients. Intervention: Introduction of electronic order sets designed to reduce inpatient fluoroquinolone prescribing. Results: Among 163,117 admissions, there were 683 cases of HO-CDI and 1,104 cases of PD-CDI. In the context of a 2% month-to-month decline starting in the preintervention period ( P &lt; .01), we observed a reduction in fluoroquinolone days of therapy per 1,000 patient days of 21% after the intervention (level change, P &lt; .05). HO-CDI rates were stable throughout the study period. In contrast, we also detected a change in the trend of PD-CDI rates from a stable monthly rate in the preintervention period to a monthly decrease of 2.5% in the postintervention period ( P &lt; .01). Conclusions: Our systemwide intervention reduced inpatient fluoroquinolone use immediately, but not HO-CDI. However, a downward trend in PD-CDI occurred. Relying on outcome measures limited to the inpatient setting may not reflect the full impact of inpatient stewardship efforts.","journal":"Antimicrobial Stewardship & Healthcare Epidemiology","year":2021,"id":207900,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.961,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":385372,"name":"Udodirim Onwubiko","orcid":"0000-0001-8223-5716","position":1,"is_corresponding":false},{"id":793916,"name":"Julianne Kubes","orcid":"0000-0002-6717-3104","position":2,"is_corresponding":false},{"id":614474,"name":"Benjamin Albrecht","orcid":"0000-0001-5267-8604","position":3,"is_corresponding":false},{"id":794476,"name":"Kristen Paciullo","orcid":null,"position":4,"is_corresponding":false},{"id":585458,"name":"Jessica Howard‐Anderson","orcid":"0000-0001-9924-0458","position":5,"is_corresponding":false},{"id":603592,"name":"Sujit Suchindran","orcid":"0009-0000-6300-6491","position":6,"is_corresponding":false},{"id":794477,"name":"Ronald P. Trible","orcid":null,"position":7,"is_corresponding":false},{"id":232744,"name":"Jesse T. Jacob","orcid":"0000-0001-9811-6260","position":8,"is_corresponding":false},{"id":793917,"name":"Sarah H. Yi","orcid":"0000-0003-0913-5836","position":9,"is_corresponding":false},{"id":585455,"name":"Dana Goodenough","orcid":"0000-0003-4642-0839","position":10,"is_corresponding":false},{"id":271489,"name":"Scott K. Fridkin","orcid":"0000-0003-4892-693X","position":11,"is_corresponding":false},{"id":539226,"name":"Mary Elizabeth Sexton","orcid":"0000-0001-6845-5595","position":12,"is_corresponding":false},{"id":774891,"name":"Zanthia Wiley","orcid":"0000-0002-9718-3709","position":13,"is_corresponding":false},{"id":793915,"name":"K. A. Jones","orcid":"0000-0003-1720-3798","position":0,"is_corresponding":true}],"reference_count":31,"raw_metadata":null,"created_at":"2026-07-18T23:51:53.662668Z","pmid":"36168449","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}