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. 2023 May 26;12(6):964.
doi: 10.3390/antibiotics12060964.

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

Yu Mi Wi  1 , Ki Tae Kwon  2 , Cheon-Hoo Jeon  1 , Si-Ho Kim  1 , Soyoon Hwang  2 , Sohyun Bae  3 , Yoonjung Kim  3 , Hyun-Ha Chang  3 , Shin-Woo Kim  3 , Hae Suk Cheong  4 , Shinwon Lee  5 , Dong Sik Jung  6 , Kyung Mok Sohn  7 , Chisook Moon  8 , Sang Taek Heo  9 , Bongyoung Kim  10 , Mi Suk Lee  11 , Jian Hur  12 , Jieun Kim  10 , Young Kyung Yoon  13 , Antimicrobial Stewardship Research Committee Of Korean Society For Antimicrobial Therapy
Affiliations

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

Yu Mi Wi et al. Antibiotics (Basel). .

Abstract

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.

Keywords: antimicrobial stewardship programs; carbapenem; handshake.

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Conflict of interest statement

All authors report no conflict of interest relevant to this article.

Figures

Figure 1
Figure 1
Antimicrobial use in the 14 days before death.
See this image and copyright information in PMC

References

    1. Breilh D., Texier-Maugein J., Allaouchiche B., Saux M.C., Boselli E. Carbapenems. J. Chemother. 2013;25:1–17. doi: 10.1179/1973947812Y.0000000032. - DOI - PubMed
    1. Armand-Lefèvre L., Angebault C., Barbier F., Hamelet E., Defrance G., Ruppé E., Bronchard R., Lepeule R., Lucet J.-C., El Mniai A., et al. Emergence of Imipenem-Resistant Gram-Negative Bacilli in Intestinal Flora of Intensive Care Patients. Antimicrob. Agents Chemother. 2013;57:1488–1495. doi: 10.1128/AAC.01823-12. - DOI - PMC - PubMed
    1. Versporten A., Zarb P., Caniaux I., Gros M.-F., Drapier N., Miller M., Jarlier V., Nathwani D., Goossens H., Koraqi A., et al. Antimicrobial consumption and resistance in adult hospital inpatients in 53 countries: Results of an internet-based global point prevalence survey. Lancet Glob. 2018;6:e619–e629. doi: 10.1016/S2214-109X(18)30186-4. - DOI - PubMed
    1. Kwak Y.G., Moon C., Kim E.S., Kim B.-N. Frequent Prescription of Antibiotics and High Burden of Antibiotic Resistance among Deceased Patients in General Medical Wards of Acute Care Hospitals in Korea. PLoS ONE. 2016;11:e0146852. doi: 10.1371/journal.pone.0146852. - DOI - PMC - PubMed
    1. Yoon Y.K., Yang K.S., Lee S.E., Kim H.J., Sohn J.W., Kim M.J. Effects of Group 1 versus Group 2 Carbapenems on the Susceptibility of Acinetobacter baumannii to Carbapenems: A Before and After Intervention Study of Carbapenem-Use Stewardship. PLoS ONE. 2014;9:e99101. doi: 10.1371/journal.pone.0099101. - DOI - PMC - PubMed

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