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Updated: May 12, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Antimicrobial use and stewardship programs among dialysis centers.

Erika M C D'Agata¹

¹Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. edagata@bidmc.harvard.edu

Seminars in Dialysis

|April 23, 2013

Summary

Judicious antimicrobial prescribing is crucial for chronic hemodialysis patients due to high rates of multidrug-resistant organisms. Antimicrobial stewardship programs effectively reduce inappropriate use and costs in this vulnerable population.

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Published on: July 20, 2022

Area of Science:

Nephrology
Infectious Diseases
Public Health

Background:

Chronic hemodialysis patients exhibit high rates of multidrug-resistant organism colonization and infection.
This population experiences extensive antimicrobial exposure, necessitating judicious prescribing practices.

Purpose of the Study:

To highlight the significant rates of inappropriate antimicrobial prescribing in chronic hemodialysis patients.
To identify key strategies for implementing effective antimicrobial stewardship programs in dialysis centers.

Main Methods:

Review of antimicrobial prescribing patterns in chronic hemodialysis patients.
Analysis of reasons for inappropriate antimicrobial use, including failure to de-escalate, incorrect infection criteria, and guideline non-adherence for surgical prophylaxis.
Outline of effective antimicrobial stewardship program strategies.

Main Results:

Thirty to forty percent of chronic hemodialysis patients receive antimicrobials annually, with up to 30% prescribed inappropriately.
Commonly misused antimicrobials include vancomycin, third/fourth-generation cephalosporins, and cefazolin.
Antimicrobial stewardship programs, employing strategies like education and prospective audit, reduce inappropriate exposure and costs.

Conclusions:

Inappropriate antimicrobial prescribing is prevalent in chronic hemodialysis patients, contributing to antimicrobial resistance.
Implementing comprehensive antimicrobial stewardship programs with dedicated teams and administrative support is essential.
Regular monitoring and evaluation of stewardship programs are necessary to ensure efficacy and compliance.