#48 – Aligning Goals: Antibiotics in End of Life Care

Drs. Molly Sinert and Jon Furuno join Dr. David Ha (@DHpharmd) to discuss the prevalence of antibiotic use and its harms and benefits in reducing suffering and providing comfort during end-of-life care. Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/ References: Sinert et al. Guidance for Safe and Appropriate Use of Antibiotics in Hospice Using a Collaborative Decision Support Tool. Accessed October 6, 2021. https://oce-ovid-com.laneproxy.stanford.edu/article/00129191-202008000-00005/HTMLA Albrecht JS, McGregor JC, Fromme EK, Bearden DT, Furuno JP. A Nationwide Analysis of Antibiotic Use in Hospice Care in the Final Week of Life. Journal of Pain and Symptom Management. 2013;46(4):483-490. doi:10.1016/j.jpainsymman.2012.09.010 Furuno JP, Noble BN, Fromme EK. Should we refrain from antibiotic use in hospice patients? Expert Review of Anti-infective Therapy. 2016;14(3):277-280. doi:10.1586/14787210.2016.1128823 Servid SA, Noble BN, Fromme EK, Furuno JP. Clinical Intentions of Antibiotics Prescribed Upon Discharge to Hospice Care. Journal of the American Geriatrics Society. 2018;66(3):565-569. doi:10.1111/jgs.15246 Gaw CE, Hamilton KW, Gerber JS, Szymczak JE. Physician Perceptions Regarding Antimicrobial Use in End-of-Life Care. Infection Control & Hospital Epidemiology. 2018;39(4):383-390. doi:10.1017/ice.2018.6 Broom J, Broom A, Good P, Lwin Z. Why is optimisation of antimicrobial use difficult at the end of life? Internal Medicine Journal. 2019;49(2):269-271. doi:10.1111/imj.14200 Kwon KT. Implementation of Antimicrobial Stewardship Programs in End-of-Life Care. Infect Chemother. 2019;51(2):89-97. doi:10.3947/ic.2019.51.2.89 Datta R, Topal J, McManus D, et al. Perspectives on antimicrobial use at the end of life among antibiotic stewardship programs: A survey of the Society for Healthcare Epidemiology of America Research Network. Infection Control & Hospital Epidemiology. 2019;40(9):1074-1076. doi:10.1017/ice.2019.194 Lopez S, Vyas P, Malhotra P, et al. A Retrospective Study Analyzing the Lack of Symptom Benefit With Antimicrobials at the End of Life. Am J Hosp Palliat Care. 2021;38(4):391-395. doi:10.1177/1049909120951748 Ito H. Antibiotics in end-of-life care: What is the driving factor? Infectious Diseases Now. Published online July 7, 2021. doi:10.1016/j.idnow.2021.07.003 Kates OS, Krantz EM, Lee J, et al. Association of Physician Orders for Life-Sustaining Treatment With Inpatient Antimicrobial Use at End of Life in Patients With Cancer. Open Forum Infectious Diseases. 2021;8(8). doi:10.1093/ofid/ofab361 Hickman SE, Nelson CA, Moss AH, Tolle SW, Perrin NA, Hammes BJ. The consistency between treatments provided to nursing facility residents and orders on the physician orders for life-sustaining treatment form. J Am Geriatr Soc. 2011; 59(11): 2091–2099. doi:10.1111/j.1532-5415.2011.03656.x. Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clinical Infectious Diseases, Volume 62, Issue 10, 15 May 2016, Pages e51–e77, https://doi.org/10.1093/cid/ciw118