Antibiotics, Vol. 12, Pages 964: Carbapenem Use in the Last Days of Life: A Nationwide Korean Study
Antibiotics doi: 10.3390/antibiotics12060964
Authors:
Yu Wi
Ki Kwon
Cheon-Hoo Jeon
Si-Ho Kim
Soyoon Hwang
Sohyun Bae
Yoonjung Kim
Hyun-Ha Chang
Shin-Woo Kim
Hae Cheong
Shinwon Lee
Dong Jung
Kyung Sohn
Chisook Moon
Sang Heo
Bongyoung Kim
Mi Lee
Jian Hur
Jieun Kim
Young Yoon
Antimicrobial Stewardship Research Committee of Korean Society for Antimicrobial Therapy
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.
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