The impact of palliative care consultation on reducing antibiotic overuse in hospitalized patients with terminal cancer at the end of life: a propensity score-weighting study.
J Antimicrob Chemother
; 78(1): 302-308, 2022 12 23.
Article
em En
| MEDLINE
| ID: mdl-36424671
ABSTRACT
OBJECTIVES:
A substantial number of hospitalized patients with terminal cancer at the end-of-life phase receive antibiotics, even with imminent death. We evaluated the impact of palliative care consultation on antibiotic use in hospitalized patients with terminal cancer during the end-of-life phase.METHODS:
We identified adult patients with metastatic solid cancer who died at a tertiary medical centre in Seoul, Republic of Korea, following at least 4â days of hospitalization (January 2018-December 2020). Patients were divided into palliative and non-palliative care consultation groups. Propensity score-weighted, multivariable logistic regression analysis was used to compare the proportion of patients receiving antibiotics within 3â days before death between the two groups.RESULTS:
Among 1143 patients analysed, 940 (82.2%) received antibiotics within 3â days before death. The proportion of patients receiving antibiotics was significantly lower (propensity score-weighted Pâ<â0.001) in the palliative care consultation group (344/468; 73.5%) than in the non-palliative care consultation group (596/675; 88.3%). The decrease in the proportion of patients receiving antibiotics in the palliative care consultation group was significant for a carbapenem (42.4% versus 22.4%; Pâ<â0.001), a glycopeptide (23.3% versus 11.1%; Pâ<â0.001) and a quinolone (30.5% versus 19.4%; Pâ=â0.012). In the multivariable logistic regression analysis, receiving palliative care consultation (adjusted OR 0.46, 95% CI 0.33-0.65; Pâ<â0.001) was independently associated with reduced antibiotic use during the end-of-life phase.CONCLUSIONS:
Palliative care consultation may reduce aggressive antibiotic use in hospitalized patients with terminal cancer during the end-of-life phase.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Antibacterianos
/
Neoplasias
Tipo de estudo:
Prognostic_studies
Limite:
Adult
/
Humans
Idioma:
En
Revista:
J Antimicrob Chemother
Ano de publicação:
2022
Tipo de documento:
Article