{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T13:12:20Z","timestamp":1788873140003,"version":"build-2803163510"},"reference-count":23,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X26104991_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Patients receiving maintenance hemodialysis are frequently exposed to antibiotics, a proportion of which may not be necessary thereby increasing the risk of antibiotic-associated adverse events. Antimicrobial stewardship programs remain underdeveloped in outpatient dialysis facilities. This study aimed to quantify antibiotic prescribing trends across in-center dialysis units and identify patient- and facility-level factors associated with decreased antibiotic use to inform the future stewardship strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104991_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective observational cohort study among 16 in-center hemodialysis units<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104991_as3\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Antibiotic prescribing patterns and patient- and unit-level characteristics were analyzed among patients receiving maintenance hemodialysis from April 1, 2021, to March 31, 2024. Antibiotic prescribing trends were analyzed using general linear models. Generalized estimating equations were used to identify factors associated with decreased prescribing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104991_as4\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 937 (26.4%) among 3,549 patients received \u22651 antibiotic dose, with an average of 15.36 doses per 100 patient-months, ranging from 4.82 to 30.87 doses\/100 patient months. Types and frequency of antibiotics prescribed among units varied considerably. Trends in antibiotic prescribing did not decrease among 10 (62.5%) of the in-center hemodialysis units. Patient-level characteristics in units associated with a decrease in prescribing included Black race, Hispanic ethnicity, age 56\u201365, and diabetes as the cause of kidney failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104991_as5\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>There is substantial variability in antibiotic prescribing across dialysis units. Decreasing trends in prescribing were observed in a subset of units and were associated with patient-level factors. These findings support the need for developing and implementing antimicrobial stewardship programs targeting the outpatient dialysis setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2026.10499","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T07:19:49Z","timestamp":1783322389000},"page":"923-930","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Trends in antibiotic prescribing patterns in sixteen in-center dialysis units"],"prefix":"10.1017","volume":"47","author":[{"given":"Ankur","family":"Shah","sequence":"first","affiliation":[{"name":"Brown University Warren Alpert Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4149-9146","authenticated-orcid":false,"given":"Cheston","family":"Cunha","sequence":"additional","affiliation":[{"name":"Brown University Warren Alpert Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filipe","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Rhode Island Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5079-9998","authenticated-orcid":false,"given":"Erika","family":"Dagata","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05gq02987","id-type":"ROR","asserted-by":"publisher"}],"name":"Brown University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"S0899823X26104991_ref3","first-page":"1","article-title":"New antimicrobial stewardship standard","volume":"36","journal-title":"Jt Comm Perspect"},{"key":"S0899823X26104991_ref18","doi-asserted-by":"publisher","DOI":"10.1177\/1062860618824153"},{"key":"S0899823X26104991_ref9","doi-asserted-by":"publisher","DOI":"10.1017\/ash.2025.37"},{"key":"S0899823X26104991_ref16","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4899-3242-6"},{"key":"S0899823X26104991_ref10","first-page":"1","article-title":"Prevalence and trends of Clostridioides difficile infection among persons requiring maintenance hemodialysis: a systematic review and meta-analysis","volume":"23","author":"Elfanagely","year":"2022","journal-title":"Infect Control Hosp Epidemiol"},{"key":"S0899823X26104991_ref7","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2019.219"},{"key":"S0899823X26104991_ref1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.1938"},{"key":"S0899823X26104991_ref12","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2013091028"},{"key":"S0899823X26104991_ref4","doi-asserted-by":"crossref","unstructured":"4. Stenvinkel, P , Ketteler, M , Johnson, RJ , et al.Int 2005;67:1216\u20131233.","DOI":"10.1111\/j.1523-1755.2005.00200.x"},{"key":"S0899823X26104991_ref20","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2025.76"},{"key":"S0899823X26104991_ref6","doi-asserted-by":"publisher","DOI":"10.1086\/669869"},{"key":"S0899823X26104991_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"S0899823X26104991_ref21","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.12521117"},{"key":"S0899823X26104991_ref11","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2014.05.016"},{"key":"S0899823X26104991_ref23","first-page":"511","article-title":"Advancing antimicrobial stewardship in outpatient dialysis centers using the positive deviance process","volume":"46","author":"Lindberg","year":"2019","journal-title":"Nephrol Nurs J"},{"key":"S0899823X26104991_ref17","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw118"},{"key":"S0899823X26104991_ref5","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2020.08.011"},{"key":"S0899823X26104991_ref19","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2025.75"},{"key":"S0899823X26104991_ref22","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1017\/ice.2018.237","article-title":"The positive effects of an antimicrobial stewardship program targeting out-patient hemodialysis facilities","volume":"39","author":"Lindberg","year":"2018","journal-title":"Infect Control Hosp Epidemiol"},{"key":"S0899823X26104991_ref2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.8.972"},{"key":"S0899823X26104991_ref15","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/73.1.13"},{"key":"S0899823X26104991_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2016.03.034"},{"key":"S0899823X26104991_ref13","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.11411116"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X26104991","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:59:28Z","timestamp":1788872368000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X26104991\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,6]]},"references-count":23,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["S0899823X26104991"],"URL":"https:\/\/doi.org\/10.1017\/ice.2026.10499","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,6]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}