Patients with ESRD receive significantly more antibiotics
Patients with end-stage renal disease, or ESRD, receive significantly more antibiotics than patients without ESRD, according to a recent study based in New York state.
“There has been a recent push in ESRD by the American Society of Nephrology for increasing patient safety, including ways to decrease infections and drug resistance,” George N. Coritsidis, MD, renal intensivist and professor of medicine at the Icahn School of Medicine at Mount Sinai, New York, and chief of the division of nephrology at the Elmhurst Hospital Center, told Healio. “We felt this would be an interesting review to see how antibiotics circulate in the ESRD population.”
Coritsidis and colleagues performed a retrospective case-control study from 2016 to 2017 of patients in New York state with and without ESRD.
The study showed that 48,100 infections were treated in 35,369 patients with ESRD and 2,544,443 infections were treated in 3,777,314 patients without ESRD. The top infectious categories included nonspecific, skin and respiratory symptoms in those with ESRD and nonspecific, respiratory and genitourinary symptoms in those without ESRD. According to the study, the incidence proportion of antibiotic prescriptions among patients with ESRD was 520.29 per 1,000 patients, and 296.48 per 1,000 patients among those without ESRD (P < .05). Since some patients were prescribed multiple antibiotics, the rates of prescriptions were 1,359.95 per 1,000 patients among those with ESRD compared with 673.61 per 1,000 patients without ESRD.
“Antibiotic overuse and misuse may add to the increased occurrence of resistant organisms seen in ESRD. This could only have an additive effect on mortality,” Coritsidis said. “A better education effort in the use in antibiotics in ESRD patients needs to be considered and attempted primarily to non-nephrologists possibly as an antibiotic stewardship [program].”