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Inappropriate intravenous antimicrobial starts: An antimicrobial stewardship metric for hemodialysis facilities

Published online by Cambridge University Press:  29 July 2019

Phillip D. Hahn*
Affiliation:
Division of Disease Control, Philadelphia Department of Public Health, Philadelphia, Pennsylvania Council of State and Territorial Epidemiologists, Atlanta, Georgia
Mary Figgatt
Affiliation:
Division of Disease Control, Philadelphia Department of Public Health, Philadelphia, Pennsylvania
Tiina Peritz
Affiliation:
Division of Disease Control, Philadelphia Department of Public Health, Philadelphia, Pennsylvania
Susan E. Coffin*
Affiliation:
Division of Disease Control, Philadelphia Department of Public Health, Philadelphia, Pennsylvania Division of Infectious Diseases, Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania
*
Author for correspondence: Phillip D. Hahn, MPH, CPH, Division of Disease Control, Philadelphia Department of Public Health, 1101 Market St, 12th Floor, Philadelphia, PA 19131. Email: Phillip.Hahn@phila.gov. Or Susan E. Coffin, MD, MPH, Division of Disease Control, Philadelphia Department of Public Health, 1101 Market St, 12th Floor, Philadelphia, PA 19131. Email: Susan.Coffin@phila.gov
Author for correspondence: Phillip D. Hahn, MPH, CPH, Division of Disease Control, Philadelphia Department of Public Health, 1101 Market St, 12th Floor, Philadelphia, PA 19131. Email: Phillip.Hahn@phila.gov. Or Susan E. Coffin, MD, MPH, Division of Disease Control, Philadelphia Department of Public Health, 1101 Market St, 12th Floor, Philadelphia, PA 19131. Email: Susan.Coffin@phila.gov

Abstract

We assessed the appropriateness of intravenous antimicrobial starts (IVASs) in Philadelphia County hemodialysis facilities using only National Healthcare Safety Network data. We classified 57.5% of IVASs as inappropriate. These findings warrant further investigation into the determinants of inappropriate IVASs in hemodialysis facilities to enhance antimicrobial stewardship.

Type
Concise Communication
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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References

Nguyen, DB, Shugart, A, Christi, Lines, et al. National Healthcare Safety Network (NHSN) Dialysis Event Surveillance Report for 2014. Clin J Am Soc Nephrol 2017;12:11391146.CrossRefGoogle ScholarPubMed
Snyder, GM, Patel, PR, Kallen, AJ, Strom, JA, Tucker, JK, D’Agata, EM. Antimicrobial use in outpatient hemodialysis units. Infect Control Hosp Epidemiol 2013;34:349357.CrossRefGoogle ScholarPubMed
Hui, K, Nalder, M, Buising, K, et al. Patterns of use and appropriateness of antibiotics prescribed to patients receiving haemodialysis: an observational study. BMC Nephrol 2017;18:156.CrossRefGoogle ScholarPubMed
D’Agata, EM, Lindberg, CC, Lindberg, CM, et al. The positive effects of an antimicrobial stewardship program targeting outpatient hemodialysis facilities. Infect Control Hosp Epidemiol 2018;39:14001405.CrossRefGoogle ScholarPubMed
Dialysis Event Surveillance Protocol. Centers for Disease Control and Prevention website. https://www.cdc.gov/nhsn/dialysis/event/index.html. Published 2018. Accessed December 6, 2018.Google Scholar
Fleming-Dutra, KE, Hersh, AL, Shapiro, DJ, et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010–2011. JAMA 2016;315:18641873.CrossRefGoogle ScholarPubMed
Shapiro, DJ, Hicks, LA, Pavia, AT, Hersh, AL. Antibiotic prescribing for adults in ambulatory care in the USA, 2007–09. J Antimicrob Chemother 2014;69:234240.CrossRefGoogle Scholar