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. 2024 May 13;4(1):e83.
doi: 10.1017/ash.2024.75. eCollection 2024.

Trends of antibiotic use at the end-of-life of cancer and non-cancer decedents: a nationwide population-based longitudinal study (2006-2018)

Nak-Hyun Kim  1 , Kyungdo Han  2 , Eunjeong Ji  3 , Soyeon Ahn  3 , Yunsang Choi  1 , Seong Jin Choi  1 , Song Mi Moon  1 , Kyoung-Ho Song  1 , Eu Suk Kim  1 , Hong Bin Kim  1
Affiliations

Trends of antibiotic use at the end-of-life of cancer and non-cancer decedents: a nationwide population-based longitudinal study (2006-2018)

Nak-Hyun Kim et al. Antimicrob Steward Healthc Epidemiol. .

Erratum in

Abstract

Objective: This study aimed to assess the actual burden of antibiotic use among end-of-life (EOL) patients in South Korea and to compare trends between cancer and non-cancer decedents.

Design: Population-based mortality follow-back study.

Setting: Data from the Korean National Health Insurance Database, covering the period from January1, 2006, to December 31, 2018, provided for research by the National Health Insurance Service (NHIS), were used.

Participants: All decedents from 2006 to 2018 were included and categorized as cancer decedents or non-cancer decedents.

Methods: Annual antibiotic consumption rates and prescription rates were calculated, and Poisson regression was used to estimate their trends.

Results: Overall antibiotic consumption rates decreased slightly among decedents in their final month with a less pronounced annual decrease rate among cancer decedents compared to non-cancer decedents (0.4% vs 2.3% per year, P <.001). Over the study period, although narrow spectrum antibiotics were used less, utilization and prescription of broad-spectrum antibiotics steadily increased, and prescription rates were higher in cancer decedents compared to non-cancer controls. Specifically, carbapenem prescription rates increased from 5.6% to 18.5%, (RR 1.087, 95% CI 1.085-1.088, P <.001) in cancer decedents and from 2.9% to 13.2% (RR 1.115, 95% CI 1.113-1.116, P <.001) in non-cancer decedents.

Conclusions: Our findings show that patients at the EOL, especially those with cancer, are increasingly and highly exposed to broad-spectrum antibiotics. Measures of antibiotic stewardship are required among this population.

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Figures

Figure 1.
Figure 1.
Overall antibiotic consumption rates (days-of-therapy/1,000pt-days) among cancer decedents according to underlying cancer type during the last month of life.
Figure 2.
Figure 2.
Overall antibiotic consumption rates (days-of-therapy/1,000pt-days) in cancer and non-cancer decedents according to timespan preceding death (1 year, 6 months, and 1 month before death).
See this image and copyright information in PMC

References

    1. Terminal Cancer. National Cancer Institute at the National Institutes of Health. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/termin.... Accessed May 26, 2023.
    1. Ferrell BR, Temel JS, Temin S, et al. Integration of palliative care into standard oncology care: american society of clinical oncology clinical practice guideline update. J Clin Oncol 2017;35:96–112. - PubMed
    1. Crawford GB, Dzierzanowski T, Hauser K, et al. Care of the adult cancer patient at the end of life: ESMO Clinical Practice Guidelines. ESMO Open 2021;6:100225. - PMC - PubMed
    1. Marra AR, Puig-Asensio M, Balkenende E, Livorsi DJ, Goto M, Perencevich EN. Antibiotic use during end-of-life care: A systematic literature review and meta-analysis. Infect Control Hosp Epidemiol 2021;42:523–529. - PubMed
    1. Marra AR, Clore GS, Balkenende E, et al. Association of entry into hospice or palliative care consultation during acute care hospitalization with subsequent antibiotic utilization. Clin Microbiol Infect 2023;29:107 e101–107 e107. - PubMed

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