Adult, Fluoroquinolone
Conditions
Keywords
Antimicrobial stewardship, Fluoroquinolone, Antibiotic
Brief summary
A single-center, cluster-randomized controlled trial was conducted to determine the effect of Sticker reminder intervention on IV-to-PO switching of fluoquinolone.
Detailed description
A single-center, cluster-randomized controlled trial was conducted across 44 general wards at Siriraj Hospital, Thailand, from July 2020 to December 2024. The study population consisted of adult patients who received at least one dose of intravenous fluoroquinolones. Wards were randomized in a 1:1 ratio to either the sticker reminder intervention or standard care. In the intervention group, a reminder sticker was applied to patients' vital signs sheets when predefined IV-to-oral switching criteria were met. The primary outcome was the proportion of intravenous-to-oral fluoroquinolone switching in the intention-to-treat (ITT) and modified intention-to-treat (mITT) populations.
Interventions
BEHAVIORALSticker reminder
a reminder sticker was applied to the vital signs sheet of patients meeting predefined switching criteria
Sponsors
Mahidol University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Adult patients (aged ≥ 18 years) 2. Diagnosis of any infection 3. Receiving at least one dose of intravenous fluoroquinolones (ciprofloxacin, levofloxacin, or moxifloxacin)
Exclusion criteria
1. Inability to tolerate oral medications (e.g., due to severe nausea/vomiting, malabsorption, active gastrointestinal bleeding, or severe diarrhea); 2. Being in an immunodeficiency state (e.g., neutropenia \[absolute neutrophil count ≤ 500 cells/mm3\], symptomatic HIV/AIDS, history of bone marrow or organ transplantation, leukemia, or current use of immunosuppressive agents); or 3. Having severe infections requiring exclusive intravenous antimicrobial therapy (e.g., infective endocarditis, meningitis, encephalitis, brain abscess, or prosthetic device infections).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| IV-to-PO switching | From the day of initiation of fluoroquinolone to the discharge date (Up to 1 year) | Proportion of patients who underwent switching from intravenous fluoroquinolone to oral fluoroquinolone within the same hospitalization |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Length of stay | From the day of initiation of intravenous fluroquinolone to the day of discharge (up to 1 year) | The total length of hospital stay of that given admission |
| Duration of FQ therapy | From the first day to the last day of fluroquinolone use (up to 1 year) | The total duration of intravenous fluroquinolone and oral fluroquinolone (day) |
Countries
Thailand
Outcome results
None listed