Characterization of Antibiotic Use, Documented Infection and Prevalence of Multidrug-Resistant Organisms in Palliative Care Patients Admitted to a Private Hospital in Brazil: A Retrospective, Cohort Study.

Autor:	Maciel MG; Department of Geriatric and Palliative Care, Hospital São Camilo Ipiranga, São Paulo, Brazil., Fruitg M; Department of Geriatric and Palliative Care, Hospital São Camilo Ipiranga, São Paulo, Brazil., Lawall RP; Department of Geriatric and Palliative Care, Hospital São Camilo Ipiranga, São Paulo, Brazil., Maciel AT; Imed Research Group, São Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	Indian journal of palliative care [Indian J Palliat Care] 2021 Oct-Dec; Vol. 27 (4), pp. 530-537. Date of Electronic Publication: 2021 Nov 09.
DOI:	10.25259/IJPC_112_21
Abstrakt:	Objectives: Antibiotic use in palliative care patients is a frequent dilemma. The benefits of their use in terms of quality of end-of-life care or survival improvement are not clear and the potential harm and futility of this practice not well established. Our aim was to characterise the prevalence of antibiotic use, documented infection and multidrug-resistant organisms (MDROs) colonisation among palliative care patients admitted to a private hospital in Brazil. Materials and Methods: Retrospective analysis of all palliative care patients admitted to our hospital during 1 year, including demographic characteristics, diagnosis of infectious disease at admission, antibiotic use during hospital stay, infectious agents isolated in cultures, documented MDRO colonisation and hospital mortality. Results: A total of 114 patients were included in the analysis. Forty-five (39%) were male and the median age was 83 years. About 78% of the patients had an infectious diagnosis at hospital admission and 80% of the patients not admitted with an infectious diagnosis used antibiotics during their stay, out of which a great proportion of large spectrum antibiotics. Previous MDRO colonisation and hospital mortality were similar between patients admitted with or without an infectious diagnosis. Conclusion: Infection is the leading cause of hospital admission in palliative care patients. However, antibiotics prescription is also very prevalent during hospital stay of patients not admitted with an infectious condition. Mortality is very high regardless of the initial reason for hospital admission. Therefore, the impact of multiple large spectrum antibiotics prescription and consequent significant cost burden should be urgently confronted with the real benefit to these patients. Competing Interests: There are no conflicts of interest. (© 2021 Published by Scientific Scholar on behalf of Indian Journal of Palliative Care.)
Databáze:	MEDLINE
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