- •All parenteral antimicrobials administered to patients requiring chronic hemodialysis in 2 outpatient hemodialysis units over a 12-month period were quantified and assessed for appropriateness based on published guidelines.
- •A third of patients received at least 1 dose of antimicrobials, and among these, more than half received at least 1 inappropriately indicated dose.
- •Patients with a tunneled catheter access, a history of colonization or infection with a multidrug-resistant organism, and receiving hemodialysis during daytime shifts were more likely to receive antimicrobials.
- •Patients with a tunneled catheter access, receiving dialysis in unit B, and with a longer duration of hemodialysis prior to enrollment were at higher risk of receiving an inappropriately indicated antimicrobial dose.
- •Antimicrobial stewardship efforts in outpatient hemodialysis may focus on minimizing tunneled catheter use, incorporate prior history of multidrug-resistant organisms, and will likely require unit-specific practices.
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Funding/Support: Supported by the Centers for Disease Control and Prevention Division of Healthcare Quality Promotion (intergovernmental personnel agreement no. 10IPA1004108 ) and the Agency for Healthcare Research and Quality (grant no. R18HS021666 to E.M.C.D.).
Conflicts of Interest: None to report.
Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.