Frontiers in antimicrobial stewardship: antimicrobial use during end-of-life care

October 2, 2023

IMPACT member Rupak Datta, MD, PhD, and Seohyuk Lee, published a commentary highlighting the use, gaps and future direction of antimicrobial use during end-of-life care. The authors outline how antibiotic use is widespread among patients receiving palliative care and that there are many health and behavior effects to consider. They conclude that there is no single path to antimicrobial stewardship, but rather shared decision making with patients and caregivers, and an emphasis on advance care planning will ease the process.

Abstract

Improving the use of antimicrobials across healthcare settings is a national priority. While considerable literature has accumulated regarding antimicrobial stewardship across the continuum of care, new frontiers for implementation remain. Antimicrobial stewardship during end-of-life care is unique because its principles are employed in the context of palliative care. Understanding how antimicrobials facilitate palliative care – with its focus on management of symptoms, psychosocial support, and assistance with decision-making – offers new opportunities to optimize the reach and effectiveness of antimicrobial stewardship.  Nevertheless, many aspects of this area warrant increased scrutiny by stakeholders.