ArticleThe American journal of hospice & palliative care2020
Increased Length of Stay Associated With Antibiotic Use in Older Adults With Advanced Cancer Transitioned to Comfort Measures.
Article in The American journal of hospice & palliative care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Prevalence and Symptomatic Benefit of Antibiotic Use in End-of-Life Patients in Saudi Arabia: An Observational Cohort Study.Journal of palliative care · 2026Observational
- Antimicrobial use in patients with end-of-life status in intensive care units: A systematic review and meta-analysis.Fujita medical journal · 2026Article
- Broad-Spectrum Antibiotic Use at the End of Life in Patients With Advanced Cancer.JAMA network open · 2025Observational
- Antimicrobials in serious illness and end-of-life care: lifting the veil of silence.The Lancet. Infectious diseases · 2025Review
- Article
- Current trends in antimicrobial use and the role of antimicrobial stewardship in palliative oncology: a narrative review.BMC palliative care · 2025Review
- Factors Associated with Antimicrobial Use at the End-Of-Life Among Hospitalized Cancer Patients.The American journal of hospice & palliative care · 2024Article
- Management of Infections in Palliative Care Patients at the End-of-Life and Active Process of Death: A Brazilian Retrospective Study.Palliative medicine reports · 2024Article
- Perceptions and Reality of Antimicrobial Prescribing During the Transition to Comfort Measures Only at an Academic Medical Center.Open forum infectious diseases · 2023Article
- Antibiotic stewardship program (ASP) in palliative care: antibiotics, to give or not to give.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2022Article
- Association of Physician Orders for Life-Sustaining Treatment With Inpatient Antimicrobial Use at End of Life in Patients With Cancer.Open forum infectious diseases · 2021Article
- 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 and hospital epidemiology · 2019Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundAntibiotic use may increase hospital length of stay (LOS) among older patients with advanced cancer who are transitioned to comfort measures.
methodsWe studied a cohort of patients with advanced cancer aged ≥65 years who were transitioned to comfort measures during admission from July 1, 2014, through November 30, 2016. We evaluated the association between antibiotic exposure and LOS using a Poisson regression model adjusted for age, gender, cancer type, comorbidities, infection, and intensive care unit admission.
resultsAmong 461 patients with advanced cancer, median age was 74 years (range: 65-99), 49.0% (n = 226) were female, and 20.6% (n = 95) had liquid tumors. Overall, 82.9% (n = 382) received ≥1 antibiotic and 64.6% (n = 298) had ≥1 infection diagnosis during hospitalization. Infection diagnoses commonly included sepsis (35%, n = 161/461), pneumonia (25%, n = 117/461), and urinary tract infection (14%, n = 66/461). Among those receiving antibiotics, the most common choices included vancomycin (79%, n = 300/382), cephalosporins (63%, n = 241/382), and penicillins (45%, n = 172/382). In a multivariable Poisson regression model, LOS was 34% longer (count ratio = 1.34, [95% confidence interval: 1.20-1.51]) among those exposed versus unexposed to antibiotics.
conclusionsAntibiotic use among patients with advanced cancer who are transitioned to comfort measures is associated with longer LOS. These data illustrate the importance of tradeoffs associated with antibiotic use, such as unintended increased LOS, when striving for goal-concordant care near the end of life.
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