Navigation Links
Nearly a third of antibiotic prescriptions for dialysis patients inappropriate
Date:3/12/2013

Patients who receive hemodialysis are at a significant risk of developing infections, a leading cause of hospitalization and death in this patient population. A new study highlights the need to improve antibiotic use in outpatient dialysis facilities as data shows nearly a third of antibiotic prescriptions are deemed inappropriate. The study is published in the April issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.

The United States Renal Data System reported that from 1993 to 2010, the number of hospitalizations due to infection rose by more than 45 percent in chronic hemodialysis (CHD) patients. They noted that patients receiving dialysis were admitted to the hospital two times per year for an average of 12 days, and 36 percent were readmitted within 30 days. During hospitalizations, CHD patients appeared to have contributed to the spread and acquisition of multi-drug resistant organisms (MDROs) among other hospitalized patients.

"The high prevalence of MDROs harbored by CHD patients compared to that in lower-risk populations, compounded by the rising rate of infections, emphasizes the need to reduce the emergence and spread of MDROs in this population," said Graham Snyder, lead researcher in the study. "Despite the high prevalence, there are limited data pertaining to antibiotic use in outpatient hemodialysis units."

Researchers from Boston, in collaboration with the Centers for Disease Control and Prevention, calculated the total antibiotic use over a retrospective 35-month period, and additionally followed 278 patients during a 12-month period and analyzed the antibiotics these patients received at two outpatient dialysis units.

Inappropriate administration of antibiotics was defined as giving antibiotics when criteria for infection based on national guidelines published by major infectious diseases and nephrology societies were not met; failing to use a more narrow-spectrum antimicrobial agent based on culture results; and using antimicrobial prophylaxis when indications for surgical prophylaxis were not met.

A total of 1,003 antimicrobial doses were administered during the 12-month study period. Nearly one in three patients received at least one antimicrobial dose.

Of the 1,003 doses of antibiotics, nearly one-third of antibiotic doses were classified as inappropriate. The most common reason for inappropriate administration was that conditions for infection were not met. Blood-stream infections were the most common misdiagnosed infection based on unmet criteria.

The second most common reason for inappropriate antibiotic administration was using a potent antibiotic when an equally efficacious and available antibiotic less likely to promote resistant bacteria could have been used. The antibiotics most likely to be inappropriately prescribed included vancomycin, which is commonly used for skin-related infections and infections associated with the vascular access used for dialysis, and third or fourth generation cephalosporins, which are used for a broad array of infections.

"Since antimicrobial exposure is the main risk factor for the emergence and spread of MDROs, minimizing inappropriate antimicrobial use is imperative. The findings of this study provide important information toward minimizing inappropriate antimicrobial use in outpatient dialysis units. By identifying key areas, including best practices in documentation and classification of infections, and a focus on antibiotic de-escalation, this study should lead to future antimicrobial stewardship interventions tailored to outpatient dialysis units," said Snyder.


'/>"/>
Contact: Kate Enos
kenos@gymr.com
202-745-5071
Society for Healthcare Epidemiology of America
Source:Eurekalert

Related medicine news :

1. Nearly 1 in 4 grandparents store prescription medicines where children can easily find them
2. Psychiatric Patients Often Wait Nearly 12 Hours in ER
3. Southeast program to fight diabetes awarded nearly $10 million by HHS
4. Clemson professor awarded nearly $600,000 4-year grant to study language of plants
5. Lung changes are present in nearly half of ACPA positive RA patients at disease onset
6. Recessions bite: Nearly 4 million Californians struggled to put food on table during downturn
7. Einstein receives nearly $5 million to study how Ebola causes infection
8. Scripps Florida scientists awarded nearly $1.5 million to develop new approaches to treat cancer
9. GW School of Nursing receives nearly $1 million grant to diversify nursing workforce
10. Clemson researcher awarded nearly $245,000 to study automation trust and dependence
11. Pain Reported by Nearly Half With Type 2 Diabetes
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... June 27, 2016 , ... TherapySites, the ... affiliation with Tennessee Counseling Association. This new relationship allows TherapySites to ... Counseling Association, adding exclusive benefits and promotional offers. , "TCA is extremely excited ...
(Date:6/27/2016)... ... June 27, 2016 , ... TopConsumerReviews.com recently awarded their highest five-star ... , Millions of individuals in the United States and Canada wear eyeglasses. Once considered ... both correct vision and make a fashion statement. Even celebrities use glasses as a ...
(Date:6/26/2016)... ... 26, 2016 , ... Pixel Film Studios Released ProSlice Levels, a Media Slicing ... their videos a whole new perspective by using the title layers in ProSlice ... , ProSlice Levels contains over 30 Different presets to choose from. FCPX ...
(Date:6/26/2016)... ... June 26, 2016 , ... Many women ... diagnosed with endometriosis. These women need a treatment plan to not only alleviate ... that can help for preservation of fertility and ultimately achieving a pregnancy. The ...
(Date:6/25/2016)... ... ... Bruton Memorial Library on June 21 due to a possible lice infestation, as reported by ... lice: the parasite’s ability to live away from a human host, and to infest common ... the event that lice have simply gotten out of control. , As lice are a ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... , June 24, 2016 The Academy ... of recommendations that would allow biopharmaceutical companies ... with entities that make formulary and coverage decisions, a ... "value" of new medicines. The recommendations address ... not appear on the drug label, a prohibition that ...
(Date:6/24/2016)... Mass. and SAN CLEMENTE, Calif. , ... California -based mobile pulmonary function testing company, is now able ... PFT devices developed by ndd Medical Technologies , Inc. ... testing done in hospital-based labs.  Thanks to ndd,s EasyOne PRO ® ... , can get any needed testing done in the comfort ...
(Date:6/24/2016)... June 24, 2016 According to ... Type (Standard Pen Needles, Safety Pen Needles), Needle Length ... Growth Hormone), Mode of Purchase (Retail, Non-Retail) - Trends ... report studies the market for the forecast period of ... USD 2.81 Billion by 2021 from USD 1.65 Billion ...
Breaking Medicine Technology: