TY - JOUR
T1 - Opportunities to Improve Antibiotic Prescribing in Outpatient Hemodialysis Facilities
T2 - A Report From the American Society of Nephrology and Centers for Disease Control and Prevention Antibiotic Stewardship White Paper Writing Group
AU - Apata, Ibironke W.
AU - Kabbani, Sarah
AU - Neu, Alicia M.
AU - Kear, Tamara M.
AU - D'Agata, Erika M.C.
AU - Levenson, David J.
AU - Kliger, Alan S.
AU - Hicks, Lauri A.
AU - Patel, Priti R.
N1 - Funding Information:
Dr Kear serves on the Scientific Advisory Board for Kibow Biotech and is the Executive Director for the American Nephrology Nurses Association. Dr Kliger receives financial support from the ASN for chairing and co-chairing the Nephrologists Transforming Dialysis Safety (NTDS) and ASN COVID-19 (coronavirus disease 2019) response team, respectively. He also receives support from the National Institute of Diabetes and Digestive and Kidney Diseases for chairing the steering committee of Hemodialysis Novel Therapies Consortium, and honoraria from several universities and other organizations for lectures and workshops. Dr Levenson is a consultant to Aethlon Medical, Inc and has financial relationships with DaVita Inc.
PY - 2020
Y1 - 2020
N2 - Antibiotic use is necessary in the outpatient hemodialysis setting because patients receiving hemodialysis are at increased risk for infections and sepsis. However, inappropriate antibiotic use can lead to adverse drug events, including adverse drug reactions and infections with Clostridioides difficile and antibiotic-resistant bacteria. Optimizing antibiotic use can decrease adverse events and improve infection cure rates and patient outcomes. The American Society of Nephrology and the US Centers for Disease Control and Prevention created the Antibiotic Stewardship in Hemodialysis White Paper Writing Group, comprising experts in antibiotic stewardship, infectious diseases, nephrology, and public health, to highlight strategies that can improve antibiotic prescribing for patients receiving maintenance hemodialysis. Based on existing evidence and the unique patient and clinical setting characteristics, the following strategies for improving antibiotic use are reviewed: expanding infection and sepsis prevention activities, standardizing blood culture collection processes, treating methicillin-susceptible Staphylococcus aureus infections with β-lactams, optimizing communication between nurses and prescribing providers, and improving data sharing across transitions of care. Collaboration among the Centers for Disease Control and Prevention; American Society of Nephrology; other professional societies such as infectious diseases, hospital medicine, and vascular surgery societies; and dialysis provider organizations can improve antibiotic use and the quality of care for patients receiving maintenance hemodialysis.
AB - Antibiotic use is necessary in the outpatient hemodialysis setting because patients receiving hemodialysis are at increased risk for infections and sepsis. However, inappropriate antibiotic use can lead to adverse drug events, including adverse drug reactions and infections with Clostridioides difficile and antibiotic-resistant bacteria. Optimizing antibiotic use can decrease adverse events and improve infection cure rates and patient outcomes. The American Society of Nephrology and the US Centers for Disease Control and Prevention created the Antibiotic Stewardship in Hemodialysis White Paper Writing Group, comprising experts in antibiotic stewardship, infectious diseases, nephrology, and public health, to highlight strategies that can improve antibiotic prescribing for patients receiving maintenance hemodialysis. Based on existing evidence and the unique patient and clinical setting characteristics, the following strategies for improving antibiotic use are reviewed: expanding infection and sepsis prevention activities, standardizing blood culture collection processes, treating methicillin-susceptible Staphylococcus aureus infections with β-lactams, optimizing communication between nurses and prescribing providers, and improving data sharing across transitions of care. Collaboration among the Centers for Disease Control and Prevention; American Society of Nephrology; other professional societies such as infectious diseases, hospital medicine, and vascular surgery societies; and dialysis provider organizations can improve antibiotic use and the quality of care for patients receiving maintenance hemodialysis.
KW - antibiotic resistance
KW - antibiotic stewardship
KW - Antibiotic use
KW - bloodstream infection
KW - Clostridioides difficile
KW - end-stage renal disease (ESRD)
KW - hemodialysis (HD)
KW - infections
KW - methicillin-susceptible Staphylococcus aureus (MSSA)
KW - multidrug-resistant organism (MDRO)
KW - peritoneal dialysis (PD)
KW - prescribing practices
KW - sepsis
KW - vancomycin
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U2 - 10.1053/j.ajkd.2020.08.011
DO - 10.1053/j.ajkd.2020.08.011
M3 - Article
C2 - 33045256
AN - SCOPUS:85097753082
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
SN - 0272-6386
ER -