Antimicrobial use in patients receiving extracorporeal membrane oxygenation (ECMO) is poorly described. In this study, evaluating antimicrobial use at a single center without ECMO-specific antimicrobial prophylaxis protocols, antimicrobials were prescribed on 85% of ECMO days. Targeted antimicrobial days (52%) were more common than empiric (29%) or non-ECMO prophylaxis (4%) days.

Introduction

One of the most common complications in patients receiving extracorporeal membrane oxygenation (ECMO) is the development of healthcare-associated infections, which are associated with significant morbidity and mortality.^{Reference Marcus, Shah, Peek and MacLaren1} To prevent infection, a variety of strategies are used, including prophylactic antibiotics, which are used in roughly half of ECMO centers.^{Reference Glater-Welt, Schneider, Zinger, Rosen and Sweberg2} While the use of narrow-spectrum prophylactic antibiotics has been associated with the decreased use of broad-spectrum antibiotics, data is mixed on their utility in decreasing infections or improving patient outcomes.^{Reference Shah, Sampathkumar and Stevens3,Reference Orso, Fodale and Fossati4}

With the global efforts for antimicrobial stewardship on ECMO,^{Reference Abdulaziz, Alhajri and So5} there is a need to better characterize antimicrobial use in patients receiving ECMO in all settings. In this study, we describe antimicrobial use at a single center without any ECMO-specific protocols for antimicrobial prophylaxis.