Fluoroquinolone Restriction as an Effective Antimicrobial Stewardship Intervention

  • Kimberly C. Claeys
  • Teri L. Hopkins
  • Ana D. Vega
  • Emily L. Heil
Healthcare Associated Infections (G Bearman and D Morgan, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Healthcare Associated Infections


Purpose of review

Fluoroquinolones are a commonly prescribed antibiotic class that has come under scrutiny in recent years due to mounting evidence of association between adverse drug events, C. difficile infection and isolation of antibiotic-resistant bacteria.

Recent findings

Inpatient antimicrobial stewardship (AMS) programs have a toolbox of potential interventions to curb inappropriate antibiotic use, prevent antibiotic-associated adverse drug events, and avoid unnecessary costs of care. Fluoroquinolone restriction policies in the acute care setting have demonstrated beneficial effects, including decreased rates of C. difficile infection and ESBL-producing Enterobacteriaceae. However, a simple blanket restriction policy may “squeeze the antibiotic balloon” and will likely be insufficient if not implemented in conjunction with other AMS interventions.


There is a growing body of evidence to support formulary restriction of fluoroquinolones in the acute care setting to decrease rates of C. difficile infection and development of ESBL-producing organisms. Data on how to best implement these restrictions or how to implement outside of acute care settings is limited.


Antibiotic restriction C. difficile Extended-spectrum beta-lactamase Fluoroquinolones 


Compliance with Ethical Standards

Conflict of Interest

Kimberly C. Claeys, Teri L. Hopkins, Ana D. Vega, and Emily L. Heil declare they have no conflicts of interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Kimberly C. Claeys
    • 1
    • 2
  • Teri L. Hopkins
    • 3
  • Ana D. Vega
    • 1
  • Emily L. Heil
    • 1
    • 2
  1. 1.Department of Pharmacy Practice and ScienceUniversity of Maryland School of PharmacyBaltimoreUSA
  2. 2.Department of PharmacyUniversity of Maryland Medical CenterBaltimoreUSA
  3. 3.Department of PharmacySouth Texas Veterans Health Care SystemSan AntonioUSA

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