Comparison of therapeutic interchange with standard educational tools for influencing fluoroquinolone prescribing

The abilities of therapeutic interchange (TI) and standard educational tool s (SET) to change prescribing habits were compared. We evaluated the replacement of ciprofloxacin with levofloxacin in a four-h ospital health system during a 14-month study period. Two hospitals used TI and two SET. The demographics, sites of infection, and severity of illness were analyzed for 554 patients treated at SET hospitals and 1323 patients treated at TI hospitals during a total of 2040 hospitalizations over a 14-m onth period. In TI hospitals, 97% of patients received levofloxacin, whereas 43% receive d levofloxacin in SET hospitals (p < 0.001). Clinical outcomes were not sig nificantly different fot the two groups, although more patients in the SET hospitals received combination antimicrobial therapy. Differences in saving s per patient were significant between TI hospitals ($60) and SET hospitals ($37) (p < 0.001). The total annualized savings for all four hospitals was $156,444. TI was more effective than SET in facilitating changes in prescribing patte rns in a health care system and resulted in significant cost savings to hos pitals and payers.