Use of Antibiotics Within the Last 14 Days of Life in Korean Patients: A Nationwide Studyopen access
- Authors
- Wi, Yu Mi; Kwon, Ki Tae; Hwang, Soyoon; Bae, Sohyun; Kim, Yoonjung; Chang, Hyun-Ha; Kim, Shin-Woo; Cheong, Hae Suk; Lee, Shinwon; Jung, Dong Sik; Sohn, Kyung Mok; Moon, Chisook; Heo, Sang Taek; Kim, Bongyoung; Lee, Mi Suk; Hur, Jian; Kim, Jieun; Yoon, Young Kyung
- Issue Date
- Mar-2023
- Publisher
- KOREAN ACAD MEDICAL SCIENCES
- Keywords
- Terminally Ill; Antimicrobial Agents; Carbapenem; Inappropriate; Antimicrobial Stewardship Programs
- Citation
- JOURNAL OF KOREAN MEDICAL SCIENCE, v.38, no.9, pp.1 - 10
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- JOURNAL OF KOREAN MEDICAL SCIENCE
- Volume
- 38
- Number
- 9
- Start Page
- 1
- End Page
- 10
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/186049
- DOI
- 10.3346/jkms.2023.38.e66
- ISSN
- 1011-8934
- Abstract
- BACKGROUND: Antimicrobial prescriptions for serious chronic or acute illness nearing its end stages raise concerns about the potential for futile use, adverse events, increased multidrug-resistant organisms, and significant patient and social cost burdens. This study investigated the nationwide situation of how antibiotics are prescribed to patients during the last 14 days of life to guide future actions.
METHODS: This nationwide multicenter retrospective cohort study was conducted at 13 hospitals in South Korea from November 1 to December 31, 2018. All decedents were included in the study. Antibiotic use during the last two weeks of their lives was investigated.
RESULTS: A total of 1,201 (88.9%) patients received a median of two antimicrobial agents during the last two weeks of their lives. Carbapenems were prescribed to approximately half of the patients (44.4%) in the highest amount (301.2 days of therapy per 1,000 patient-days). Among the patients receiving antimicrobial agents, 63.6% were inappropriate and only 327 patients (27.2%) were referred by infectious disease specialists. The use of carbapenem (odds ratio [OR], 1.51; 95% confidence interval [CI], 1.13-2.03; P = 0.006), underlying cancer (OR, 1.56; 95% CI, 1.20-2.01, P = 0.047), underlying cerebrovascular disease (OR, 1.88; 95% CI, 1.23-2.89, P = 0.004), and no microbiological testing (OR, 1.79; 95% CI, 1.15-2.73; P = 0.010) were independent predictors for inappropriate antibiotic prescribing.
CONCLUSION: A considerable number of antimicrobial agents are administered to patients with chronic or acute illnesses nearing their end-of-life, a high proportion of which are prescribed inappropriately. Consultation with an infectious disease specialist, in addition to an antimicrobial stewardship program, may be necessary to induce the optimal use of antibiotics.
- Files in This Item
-
- Appears in
Collections - 서울 의과대학 > 서울 내과학교실 > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/186049)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.