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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Implementing an antimicrobial stewardship program in out-patient dialysis units

Cheston B Cunha1, Erika M C D'Agata

  • 1Division of Infectious Diseases, Brown University, Warren Alpert Medical School, Providence, Rhode Island, USA.

Current Opinion in Nephrology and Hypertension
|September 17, 2016
PubMed
Abstract

Insights

Antimicrobial stewardship programs (ASP) are crucial for combating rising multidrug-resistant organisms (MDRO) in chronic hemodialysis patients. Implementing ASP can reduce mortality, adverse events, and costs while improving antimicrobial susceptibility.

Area of Science:

  • Infectious Diseases
  • Nephrology
  • Public Health

Background:

  • Chronic hemodialysis patients face increasing rates of multidrug-resistant organisms (MDRO).
  • Antimicrobial exposure is a primary driver for MDRO emergence and spread.
  • A significant percentage of antimicrobial doses in outpatient dialysis units are potentially unnecessary.

Purpose of the Study:

  • To review the essential components and interventions of antimicrobial stewardship programs (ASP).
  • To emphasize the importance of ASP in the context of chronic hemodialysis settings.

Main Methods:

  • Review of existing evidence-based guidelines from professional societies.
  • Adaptation of recommendations for the outpatient dialysis environment.

Main Results:

  • Guidelines for ASP development and implementation exist.
  • Many recommendations are adaptable to outpatient dialysis.

Conclusions:

  • Implementing ASP in outpatient dialysis settings can decrease mortality and adverse events.
  • ASP can lead to reduced healthcare costs and improved antimicrobial susceptibility rates.

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