Abstract Introduction Fluoroquinolone (FQ) co-administration with multivalent cations can decrease the bioavailability of the FQ significantly. This interaction is an independent risk factor for FQ resistance, which is a concern as more clinical trials and guidelines support routine use of oral antimicrobials. Methods We examined the incidence of FQ drug–drug interactions (DDIs) in a quality improvement study after implementation of a bundle of interventions including nursing education, updated medication administration record (MAR) comments and new administration times. Results In the subgroup of patients (n = 101) who had a multivalent cation administered on the same day as a FQ, co-administration within 2 hours of the FQ was higher in the pre-intervention group as compared to the post-intervention group (62% versus 22%, P 0.001). Conclusion The bundle of interventions decreased but did not eliminate the interaction. With the interaction as an independent risk factor for resistance and increasing use of oral antibiotics, stewardship programmes should consider implementing similar interventions.
Siegrist et al. (Mon,) studied this question.
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