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Updated: Jul 7, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

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

Published on: August 30, 2018

Trends in antibiotic prescribing patterns in sixteen in-center dialysis units

Ankur Shah1, Cheston Cunha1, Filipe Monteiro2

  • 1Brown University Warren Alpert Medical School, USA.

Infection Control and Hospital Epidemiology
|July 6, 2026
PubMed
Abstract

Insights

Antibiotic prescribing varies widely in hemodialysis units. Decreased use was linked to patient factors, highlighting the need for antimicrobial stewardship programs in dialysis care.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Public Health

Background:

  • Antibiotic overuse in maintenance hemodialysis patients increases adverse events.
  • Antimicrobial stewardship programs are lacking in outpatient dialysis facilities.

Purpose of the Study:

  • Quantify antibiotic prescribing trends in in-center hemodialysis units.
  • Identify patient and facility factors associated with reduced antibiotic use.
  • Inform antimicrobial stewardship strategies for dialysis settings.

Main Methods:

  • Retrospective observational cohort study of 16 in-center hemodialysis units.
  • Analysis of antibiotic prescribing patterns from April 2021 to March 2024.
  • Statistical modeling (general linear models, GEE) to identify prescribing trends and associated factors.

Main Results:

  • 26.4% of 3,549 patients received antibiotics, with significant variation in prescribing rates (4.82-30.87 doses/100 patient-months).
  • Antibiotic prescribing did not decrease in 62.5% of units.
  • Decreased prescribing was associated with patient factors: Black race, Hispanic ethnicity, age 56-65, and diabetes as cause of kidney failure.

Conclusions:

  • Substantial variability exists in antibiotic prescribing across hemodialysis units.
  • Decreasing prescribing trends were observed in some units and linked to patient characteristics.
  • Development and implementation of antimicrobial stewardship programs are crucial for outpatient dialysis settings.

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