Patterns of use and appropriateness of antibiotics prescribed to patients receiving haemodialysis: an observational study

BMC Nephrology

Research Article

Katrina Hui¹  Carl M. J. Kirkpatrick¹  David C. M. Kong¹  Eugenie Pedagogos²  Khai Y Ooi³  Aspasia Pefanis³  Michelle Nalder⁴  Craig Nelson⁵  Kirsty Buising⁶ 

[1] Centre for Medicine Use and Safety, Monash University, Melbourne, Australia;Department of Nephrology, Royal Melbourne Hospital, Melbourne, Australia;Department of Nephrology, Western Health, Melbourne, Australia;Department of Pharmacy, Royal Melbourne Hospital, Melbourne, Australia;The University of Melbourne, Melbourne, Australia;Western Centre for Health Research and Education, Western Health, Melbourne, Australia;Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Australia;The University of Melbourne, Melbourne, Australia;

关键词: Antibiotics;    Dialysis;    End stage renal disease;    Infectious diseases;    Prescribing patterns;   

DOI  :  10.1186/s12882-017-0575-9

 received in 2016-12-05, accepted in 2017-05-05,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThere are limited published data on the types and appropriateness of oral and intravenous (IV) antibiotics prescribed to patients receiving haemodialysis. This information is critical to optimise antibiotic prescribing. Therefore this study aims to describe the patterns of use and the appropriateness of oral and IV antibiotics prescribed to patients receiving haemodialysis.MethodsThis was a prospective, observational study across four community and two hospital inpatient haemodialysis units in Melbourne, Australia. Data were collected from July 2014 to January 2015 from participants. Antibiotic regimens prescribed were compared with nationally available antibiotic guidelines and then classified as being either appropriate, inappropriate or not assessable by an expert multidisciplinary team using the National Antimicrobial Prescribing Survey tool.ResultsOverall, 114 participants consented to this study where 55.3% (63/114) received antibiotics and 235 antibiotic regimens were prescribed at a rate of 69.1 antibiotic regimens/100 patient-months. The most common oral antibiotics prescribed were amoxycillin/clavulanic acid and cephalexin. The most common IV antibiotics prescribed were vancomycin, piperacillin/tazobactam, cephazolin and ceftriaxone. The percentage of inappropriate antibiotic regimens prescribed were 34.9% (15/43) in the community setting and 22.1% (40/181) in the hospital setting. Furthermore, 29.4% (30/102) of oral and 20.5% (25/122) of IV antibiotic regimens were inappropriate with incorrect dosing as the primary reason.ConclusionAlthough this study is limited by the sample size, it describes the high antibiotic exposure that patients receiving haemodialysis experience. Of concern is inappropriate dose and frequency being a major issue. This requires interventions focused on the quality use of medicines and antimicrobial stewardship aspects of prescribing in this population.

【 授权许可】

CC BY   
© The Author(s). 2017