An audit on antibiotic use at the end of life in inpatient hospice patients – Are we contributing to over-medicalization of dying?

AbstractBackgroundThe use of antibiotics is common in patients under hospice care, although there are no definite guidelines on its use at the end of life. The excessive use of antibiotics, especially in the terminal phase when its benefit is questionable, may encourage development of antibiotic resistance and add to the cost and burden of care.ObjectiveWe conducted an audit on the use of antibiotics during the inpatient hospice stay, studying the indications, effectiveness, and appropriateness of its use.MethodsWe conducted a retrospective case note review of the use of antibiotics in patients who died in an inpatient hospice over a 3-month period. We extracted data on the use of antibiotics, type of infections, symptomatic response to antibiotics, and timing of antibiotic use in relation to death.ResultsTwenty-two (17.3%) out of 127 patients were treated with antibiotics during their inpatient hospice stay. Patients with symptoms of urinary tract infection such as fever, dysuria, frequency, and urgency ...