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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Antimicrobial use among patients receiving palliative care consultation
Erin Diviney Chun1, Phillip E Rodgers, Caroline A Vitale
1Department of Internal Medicine, Division of Geriatric Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
The American Journal of Hospice & Palliative Care
|December 5, 2009
Summary
Antimicrobial use was common in palliative care patients, with many receiving broad-spectrum empiric therapy for infections. Careful assessment of benefits versus burdens is crucial when palliation is the goal.
Area of Science:
- Palliative Care Medicine
- Infectious Diseases
- Geriatric Medicine
Background:
- Antimicrobial stewardship is critical in all patient populations.
- Palliative care focuses on symptom management and quality of life.
Purpose of the Study:
- To characterize antimicrobial prescribing patterns in patients receiving palliative care consultation.
- To identify common infections and antimicrobial agents used in this population.
Main Methods:
- Retrospective chart review of patients seen by Palliative Care Service.
- Data collected from January 2008 to May 2008 at a single health system.
Main Results:
- 70 of 131 (53.4%) palliative care patients received antimicrobials for 92 infections.
- Empiric therapy was used in 58.7% of cases, most commonly for respiratory and urinary tract infections.
- Piperacillin/tazobactam and vancomycin were frequently prescribed; 22.9% of patients died in hospital.
Conclusions:
- Significant use of empiric, broad-spectrum antimicrobials was observed in end-of-life patients.
- Careful consideration of antimicrobial therapy benefits and burdens is essential in palliative care.
- Further research on optimizing antimicrobial use in palliative care is warranted.
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