Carbapenem Use in the Last Days of Life: A Nationwide Korean Study

The appropriate use of carbapenem is a critical concern for patient safety and public health, and is a national priority. We investigated the nationwide status of carbapenem prescription in patients within their last 14 days of life to guide judicious-use protocols from the previous study comprised...

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Published in:Antibiotics (Basel) 2023-05, Vol.12 (6), p.964
Main Authors: Wi, Yu Mi, Kwon, Ki Tae, Jeon, Cheon-Hoo, Kim, Si-Ho, 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, Antimicrobial Stewardship Research Committee Of Korean Society For Antimicrobial Therapy
Format: Article
Language:English
Subjects:
Antibiotics
Antimicrobial agents
antimicrobial stewardship programs
Bacteria
Bacterial infections
carbapenem
Carbapenems
Communicable diseases
Communication
Confidence intervals
Gram-negative bacteria
handshake
Infectious diseases
Mortality
Nosocomial infections
Optimization
Pathogens
Patients
Prescription writing
Prescriptions
Public health
Regression analysis
Tazobactam
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Summary:The appropriate use of carbapenem is a critical concern for patient safety and public health, and is a national priority. We investigated the nationwide status of carbapenem prescription in patients within their last 14 days of life to guide judicious-use protocols from the previous study comprised of 1350 decedents. Carbapenem use was universally controlled through computerised authorisation system at all centres during the study period. Carbapenem prescribing patterns and their optimality were evaluated. A total of 1201 patients received antimicrobial agents within the last two weeks of their lives, of whom 533 (44.4%) received at least one carbapenem. The median carbapenem treatment duration was seven days. Of the 533 patients receiving carbapenems, 510 (95.7%) patients had microbiological samples drawn and 196 (36.8%) yielded carbapenem-resistant pathogens. A total of 200 (37.5%) patients were referred to infectious disease (ID) specialists. Of the 333 patients (62.5%) who did not have ID consultations, 194 (58.2%) were assessed as "not optimal", 79 (23.7%) required escalation, 100 (30.0%) required de-escalation, and 15 (4.5%) were discontinued. Notwithstanding the existing antibiotic restriction program system, carbapenems are commonly prescribed to patients in their last days of life.
ISSN:2079-6382
2079-6382
DOI:10.3390/antibiotics12060964