Use of Diagnosis-related Group-Based Days of Therapy to Evaluate Fluoroquinolone Use Optimization Across a Large Healthcare System

Background Optimal use of fluoroquinolones (FQ) is a common antimicrobial stewardship program (ASP) target based on well-cited risk for Clostridium difficile colitis and has gained national attention in the setting of recent FDA warnings about serious side effects. Identifying appropriate metrics for benchmarking poses a significant challenge. Diagnosis-related group (DRG) can be leveraged to focus large volumes of patient data to derive DRG-based days of therapy (DOT). Novant Health identified an opportunity to improve FQ use among patients with COPD and pneumonia (PNA) across the health system and created a FQ use optimization initiative based on inter-facility data that would otherwise not have been possible using the standard DOT per 1000 patient-days (PD) metric.