Inappropriate Antibiotic Use in Outpatient Hemodialysis Clinics.

Almost 30% of about 1000 antimicrobial doses administered to patients who received care at two outpatient dialysis clinics were classified as inappropriate in a yearlong prospective study. Of these, 52.9% did not meet criteria for infection and 26.8% represented failure to choose a more narrow-spectrum antimicrobial. Bloodstream infections were the most common misdiagnosed infection. The most common inappropriately prescribed antimicrobials were vancomycin and third- or fourth-generation cephalosporins. The Infection Control and Hospital Epidemiology study included 278 patients.