Opportunities to Improve Antibiotic Prescribing in Outpatient Hemodialysis Facilities: A Report From the American Society of Nephrology and Centers for Disease Control and Prevention Antibiotic Stewardship White Paper Writing Group

Abstract

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Can intravenous antimicrobial start data reported to the National Healthcare Safety Network determine appropriateness of antibiotic use in hemodialysis patients?

“…Few studies have evaluated antibiotic use in outpatient hemodialysis centers, and the resultant estimates of inappropriate use are often challenged by limited medical record documentation. [3][4]6 Hahn et al also draw parallels between outpatient hemodialysis care and outpatient primary care settings. However, bloodstream infections may be an area for improved antibiotic prescribing-a finding that is consistent with previous studies in this setting.…”

“…However, bloodstream infections may be an area for improved antibiotic prescribing-a finding that is consistent with previous studies in this setting. [3][4]6 Collection of blood cultures prior to initiating antibiotics for suspected bloodstream infections is integral in ensuring appropriate antibiotic selection and has the potential of improving infection cure rates. 2,6 Antibiotic stewardship involves strategies to promote the optimal use of antibiotics.…”

“…[3][4]6 Collection of blood cultures prior to initiating antibiotics for suspected bloodstream infections is integral in ensuring appropriate antibiotic selection and has the potential of improving infection cure rates. 2,6 Antibiotic stewardship involves strategies to promote the optimal use of antibiotics. 6 In the hemodialysis patient population, optimal use includes administration of empiric antibiotics to treat documented and suspected infections early and tailoring antibiotics based on culture results.…”

“…2,6 Antibiotic stewardship involves strategies to promote the optimal use of antibiotics. 6 In the hemodialysis patient population, optimal use includes administration of empiric antibiotics to treat documented and suspected infections early and tailoring antibiotics based on culture results.…”

“…The authors additionally demonstrated that collection of blood cultures prior to initiating empiric treatment for suspected bloodstream infections may be an area for improved antibiotic prescribing—a finding consistent with previous studies in this setting. 4,5,7 Collection of blood cultures prior to initiating antibiotics for suspected bloodstream infections is integral to ensuring appropriate antibiotic selection and has the potential of improving infection cure rates. 2,7…”