BACKGROUND: We sought to characterize antimicrobial use among patients receiving palliative care consultation. METHODS: Retrospective review of patients seen by the Palliative Care Service at the University of Michigan Health System from January 2008 to May 2008. RESULTS: Of 131 patients seen in consultation, 70 received antimicrobials. We identified 92 infections among these 70 patients; therapy for 54 (58.7%) was empiric. Empiric therapy was most commonly prescribed for respiratory infection and urinary tract infection. Piperacillin/tazobactam (P/T) was the most frequently used agent, with 26 patients receiving P/T (37.1%); 22 of 26 received this agent empirically (84.6%, P = .005). Vancomycin was prescribed to 23 patients (32.9%). Sixteen patients (22.9%) died in hospital; another 31 were enrolled in hospice care. CONCLUSIONS: Our results suggest significant use of empiric, broad-spectrum antimicrobial therapy among hospitalized patients near the end of life. We advocate for careful assessment of potential benefits and treatment burdens of antimicrobial therapy, especially when palliation is the goal.
BACKGROUND: We sought to characterize antimicrobial use among patients receiving palliative care consultation. METHODS: Retrospective review of patients seen by the Palliative Care Service at the University of Michigan Health System from January 2008 to May 2008. RESULTS: Of 131 patients seen in consultation, 70 received antimicrobials. We identified 92 infections among these 70 patients; therapy for 54 (58.7%) was empiric. Empiric therapy was most commonly prescribed for respiratory infection and urinary tract infection. Piperacillin/tazobactam (P/T) was the most frequently used agent, with 26 patients receiving P/T (37.1%); 22 of 26 received this agent empirically (84.6%, P = .005). Vancomycin was prescribed to 23 patients (32.9%). Sixteen patients (22.9%) died in hospital; another 31 were enrolled in hospice care. CONCLUSIONS: Our results suggest significant use of empiric, broad-spectrum antimicrobial therapy among hospitalized patients near the end of life. We advocate for careful assessment of potential benefits and treatment burdens of antimicrobial therapy, especially when palliation is the goal.
Authors: Joseph H Rosenberg; Jennifer S Albrecht; Erik K Fromme; Brie N Noble; Jessina C McGregor; Angela C Comer; Jon P Furuno Journal: J Palliat Med Date: 2013-10-23 Impact factor: 2.947
Authors: Olivia S Kates; Elizabeth M Krantz; Juhye Lee; John Klaassen; Jessica Morris; Irina Mezheritsky; Ania Sweet; Frank Tverdek; Elizabeth T Loggers; Steven A Pergam; Catherine Liu Journal: Open Forum Infect Dis Date: 2021-08-02 Impact factor: 4.423
Authors: Theodoros Kelesidis; Nikolay Braykov; Daniel Z Uslan; Daniel J Morgan; Sumanth Gandra; Birgir Johannsson; Marin L Schweizer; Scott A Weisenberg; Heather Young; Joseph Cantey; Eli Perencevich; Edward Septimus; Arjun Srinivasan; Ramanan Laxminarayan Journal: Infect Control Hosp Epidemiol Date: 2015-10-12 Impact factor: 3.254
Authors: Ronald T C M van Nordennen; Jan C M Lavrijsen; Kris C P Vissers; Raymond T C M Koopmans Journal: Drugs Aging Date: 2014-07 Impact factor: 3.923