Journal article
Antibiotic use during end-of-life care: A systematic literature review and meta-analysis
Infection control and hospital epidemiology, Vol.42(5), pp.523-529
05/01/2021
DOI: 10.1017/ice.2020.1241
PMID: 33172507
Abstract
Background: We performed a systematic literature review and meta-analysis measuring the burden of antibiotic use during end-of-life (EOL) care.
Methods: We searched PubMed, CINAHL (EBSCO platform), and Embase (Elsevier platform), through July 2019 for studies with the following inclusion criteria in the initial analysis: antibiotic use in the EOL care patients (advanced dementia, cancer, organ failure, frailty or multi-morbidity). If the number of patients in palliative care consultation (PCC) was available, antibiotic use data were pooled to compare the proportion of patients who received antibiotics under PCC compared to those not receiving PCC. Random-effect models were used to obtain pooled mean differences, and heterogeneity was assessed using the I-2 value.
Results: Overall, 72 studies met the inclusion criteria and were included in the final review: 22 EOL studies included only patients with cancer; 17 studies included only patients with advanced dementia; and 33 studies included "mixed populations" of EOL patients. Although few studies reported antibiotic using standard metrics (eg, days of therapy), 48 of 72 studies (66.7%) reported antibiotic use in >50% of all patients. When the 3 studies that evaluated antibiotic use in PCC were pooled together, patients under PCC was more likely to receive antibiotics compared to patients not under PCC (pooled odds ratio, 1.73; 95% CI, 1.02-2.93).
Conclusions: Future studies are needed to evaluate the benefits and harms of using antibiotics for patients during EOL care in diverse patient populations.
Details
- Title: Subtitle
- Antibiotic use during end-of-life care: A systematic literature review and meta-analysis
- Creators
- Alexandre R. Marra - Iowa City VA Health Care SystemMireia Puig-Asensio - Veterans Health AdministrationErin Balkenende - Veterans Health AdministrationDaniel J. Livorsi - Veterans Health AdministrationMichihiko Goto - Veterans Health AdministrationEli N. Perencevich - Veterans Health Administration
- Resource Type
- Journal article
- Publication Details
- Infection control and hospital epidemiology, Vol.42(5), pp.523-529
- Publisher
- Cambridge Univ Press
- DOI
- 10.1017/ice.2020.1241
- PMID
- 33172507
- ISSN
- 0899-823X
- eISSN
- 1559-6834
- Number of pages
- 7
- Grant note
- CIN 13-412 / Center of Innovation Award from the United States Department of Veterans Affairs Health Services Research and Development Service RVR 19-477 / Special Project Funding Award from the United States Department of Veterans Affairs Health Services Research and Development Service
- Language
- English
- Date published
- 05/01/2021
- Academic Unit
- Infectious Diseases; Epidemiology; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984359779802771
Metrics
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