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Use of fluoroquinolones and third-generation cephalosporins in the emergency department: an 11-year survey

Montassier, Emmanuela,d; Corvec, Stephanea,c; Hardouin, Jean-Benoitb; Potel, Gillesa,d; Batard, Erica,d

European Journal of Emergency Medicine: December 2014 - Volume 21 - Issue 6 - p 442–446
doi: 10.1097/MEJ.0000000000000124

Fluoroquinolones and third-generation cephalosporins are particularly prone to select bacterial resistance to antibiotics. We aimed to assess the temporal trends of antibiotic use in the emergency department adults unit of an academic hospital between 2002 and 2012. Antibiotic use was converted in defined daily doses (DDD). The total antibiotic consumption tended to decrease, from 53.1±8.5 to 48.6±11.9 DDD/1000 patient visits (estimate decrease per year, −0.9±0.5 DDD/1000 visits, P=0.07). Use of third-generation cephalosporins increased significantly, from 9.7% of total antibiotic use to 22.6% (estimate per year, 1.2±0.2%, P<0.0001), whereas use of fluoroquinolones decreased from 19.5 to 12.3% (estimate per year, −0.7±0.2%, P<0.003). Given their ability to select bacterial resistance, especially extended-spectrum β-lactamases, particular attention should be paid to increasing use of third-generation cephalosporins in the emergency department.

aLaboratory EA3826 Therapeutiques cliniques et experimentales des infections

bLaboratory EA3826 4275 Biostatistique recherche clinique et mesures subjectives en sante, Faculty of Medicine, University of Nantes

cNantes University Hospital, Microbiology Laboratory

dNantes University Hospital, Emergency Department, Nantes, France

Correspondence to Eric Batard, MD, PhD, Laboratory EA3826 Therapeutiques cliniques et experimentales des infections, Faculty of Medicine, 1 rue Gaston-Veil, Nantes F-44000, France Tel/fax: +33 240 412 854; e-mail:

Received September 14, 2013

Accepted January 7, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins