Researchers assessed the rate of parenteral antimicrobial use of patients receiving chronic hemodialysis in two outpatient hemodialysis units from September 2008 through July 2011. They evaluated the appropriateness of antimicrobial doses from August 2010 through July 2011.
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The researchers defined inappropriate administration when one of the following occurred:
• Criteria for infection based on national guidelines were not met.
• A more narrow-spectrum antimicrobial on the basis of culture data was not chosen.
• Surgical prophylaxis indications were not met.
In the 12-month study period, 29.8 percent of antimicrobial doses were inappropriate. Of these inappropriate doses, 52.9 percent did not meet criteria for infection, 26.8 percent did not have a more narrow-spectrum antimicrobial and 20.3 percent did not meet criteria for surgical prophylaxis. Vancomycin and third- or fourth-generation cephalosporins were the most common inappropriately prescribed antimicrobials.
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