Patterns of use and appropriateness of antibiotics prescribed to patients receiving haemodialysis: an observational study
Abstract Background There 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 an...
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| Format: | Article |
| Language: | English |
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BMC
2017-05-01
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| Series: | BMC Nephrology |
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| Online Access: | http://link.springer.com/article/10.1186/s12882-017-0575-9 |
| _version_ | 1818953067422285824 |
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| author | Katrina Hui Michelle Nalder Kirsty Buising Aspasia Pefanis Khai Y Ooi Eugenie Pedagogos Craig Nelson Carl M. J. Kirkpatrick David C. M. Kong |
| author_facet | Katrina Hui Michelle Nalder Kirsty Buising Aspasia Pefanis Khai Y Ooi Eugenie Pedagogos Craig Nelson Carl M. J. Kirkpatrick David C. M. Kong |
| author_sort | Katrina Hui |
| collection | DOAJ |
| description | Abstract Background There 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. Methods This 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. Results Overall, 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. Conclusion Although 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. |
| first_indexed | 2024-12-20T10:00:23Z |
| format | Article |
| id | doaj.art-b386dfaae7ca45238592969dd203bee7 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-20T10:00:23Z |
| publishDate | 2017-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-b386dfaae7ca45238592969dd203bee72022-12-21T19:44:22ZengBMCBMC Nephrology1471-23692017-05-011811910.1186/s12882-017-0575-9Patterns of use and appropriateness of antibiotics prescribed to patients receiving haemodialysis: an observational studyKatrina Hui0Michelle Nalder1Kirsty Buising2Aspasia Pefanis3Khai Y Ooi4Eugenie Pedagogos5Craig Nelson6Carl M. J. Kirkpatrick7David C. M. Kong8Centre for Medicine Use and Safety, Monash UniversityDepartment of Pharmacy, Royal Melbourne HospitalVictorian Infectious Diseases Service, Royal Melbourne HospitalDepartment of Nephrology, Western HealthDepartment of Nephrology, Western HealthDepartment of Nephrology, Royal Melbourne HospitalThe University of MelbourneCentre for Medicine Use and Safety, Monash UniversityCentre for Medicine Use and Safety, Monash UniversityAbstract Background There 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. Methods This 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. Results Overall, 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. Conclusion Although 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.http://link.springer.com/article/10.1186/s12882-017-0575-9AntibioticsDialysisEnd stage renal diseaseInfectious diseasesPrescribing patterns |
| spellingShingle | Katrina Hui Michelle Nalder Kirsty Buising Aspasia Pefanis Khai Y Ooi Eugenie Pedagogos Craig Nelson Carl M. J. Kirkpatrick David C. M. Kong Patterns of use and appropriateness of antibiotics prescribed to patients receiving haemodialysis: an observational study BMC Nephrology Antibiotics Dialysis End stage renal disease Infectious diseases Prescribing patterns |
| title | Patterns of use and appropriateness of antibiotics prescribed to patients receiving haemodialysis: an observational study |
| title_full | Patterns of use and appropriateness of antibiotics prescribed to patients receiving haemodialysis: an observational study |
| title_fullStr | Patterns of use and appropriateness of antibiotics prescribed to patients receiving haemodialysis: an observational study |
| title_full_unstemmed | Patterns of use and appropriateness of antibiotics prescribed to patients receiving haemodialysis: an observational study |
| title_short | Patterns of use and appropriateness of antibiotics prescribed to patients receiving haemodialysis: an observational study |
| title_sort | patterns of use and appropriateness of antibiotics prescribed to patients receiving haemodialysis an observational study |
| topic | Antibiotics Dialysis End stage renal disease Infectious diseases Prescribing patterns |
| url | http://link.springer.com/article/10.1186/s12882-017-0575-9 |
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