CO34 | Inappropriate use of antibiotics in end-of-life patients: a single center retrospective study
Year: 2025
Type: article
Study design: Observational Study
Abstract: Premises and Purpose of the study: A 2023 report by WHO and ECDC has shown antimicrobial resistance as a threat to patients’(Pts) safety. The appropriate use of antibiotics in all healthcare settings is one of the tools to combat antibiotic resistance. Real-world data reporting antibiotic therapy (ATB) use in end-of-life Pts is limited.Materials and Methods: A single-center observational retrospective cohort study was designed to investigate the antibiotic use of all end-of-life Pts admitted to the Internal Medicine Department of a tertiary care teaching Hospital in Northern Italy. Evaluated parameters: ATB in the last 72 and 24 hours of life, ATB under sedation, discontinuation of ATB, treatment variation, culture tests, empiric and targeted ATB.Results: Between April and October ‘21, expected death occurred in 78 Pts (10.5% of all admitted Pts), 44 M, 33 F, median age 82.8 yrs (49-97), with an average hospitalization of 13.7 days. Palliative sedation was administered to 44 Pts (56%); the average duration was 21.8 hours. Urine and blood cultures were performed in 60% of Pts and 81% received empiric ATB. In 17% of cases ATB was changed from empiric to target in the last 72 hours. ATB was not interrupted in the last 72 hours in 56 Pts (71.8%) and in the last 24 hours in 44 Pts (56.4%); for 22 Pts (40%), antibiotics were administered until death. Conclusions: Our study highlights the inappropriate use of antibiotics in end-of-life Pts with expected death. Improved knowledge of multidisciplinary end-of-life management should be encouraged within an antibiotic stewardship program.
Source: Italian Journal of Medicine
Authors: Vo Van Kha, Tran Thi Huong Ly, Pham Thi Thanh Hoa, Vo Huynh Nhu, Damas Hendriansyah, Nusratuddin Abdullah, Rudy B. Leonardy, Mardiah Tahir, Samrichard Rambulangi, Firdaus Hamid, Filomena Pietrantonio, Vera Kopsaj, Francesco Rosiello, Aurora Tomassoni, Luca Moriconi, Donatella Padua, Kiki Rizki Amelia, Efendi Lukas, Nurbani Bangsawan, Isharyah Sunarno, Retno Budiarti Farid, Sriwijaya Qadar, Rabab H. Elshaikh, Ashok Kumar Sah, Abdelrahman Mohamed Abukanna, Abdulrahman Algarni, Ammar Abdelmola, Hussam Ali Osman, Tagwa Yousif Elsayed Yousif, Elryah I. Ali, Hiba Ali, Ayman Hussein Alfeel, Thanh Long Nguyen, Victor Storm, Lam Toi Phung, Cong Thien Le, Thi Thu Ha Le, Thi Hoa Nguyen, Son Tung Vu, Thien Thang Tran, Minh Hanh Vu, Van Tuan Nguyen, Francesco Ventrella, Anna Belfiore, Antonio Greco, Franco Mastroianni, Salvatore Lenti, Domenico Ruggiero, Michele Cannone, Vincenzo Ostilio Palmieri, Massimo Errico, Giuseppe Mancia, Guido Grassi, Sverre E. Kjeldsen
Language: English
Subfield: Applied Microbiology and Biotechnology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: diamond
OpenAlex ID: W4413772708