# Trends in intravenous antimicrobial start rates in outpatient hemodialysis centers, United States, 2012–2021

## TL;DR

The use of intravenous antibiotics in outpatient dialysis centers in the U.S. has steadily decreased from 2012 through 2021, including during the early stages of the COVID-19 pandemic.

## Contribution

This study provides the first comprehensive analysis of IV antimicrobial use trends in U.S. hemodialysis centers over nearly a decade.

## Key findings

- Annual adjusted IVAS rates decreased by 6.64% from 2012 to March 2020.
- IVAS rates further dropped by 8.91% from March 2020 to December 2021.
- The decline in IVAS continued during the early phase of the COVID-19 pandemic.

## Abstract

Using National Healthcare Safety Network data, an interrupted time series of intravenous antimicrobial starts (IVAS) among hemodialysis patients was performed. Annual adjusted rates decreased by 6.64% (January 2012–March 2020) and then further decreased by 8.91% until December 2021. IVAS incidence trends have decreased since 2012, including during the early COVID-19 pandemic.