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Antibiotic use during end-of-life care: A systematic literature review and meta-analysis

Published online by Cambridge University Press:  11 November 2020

Alexandre R. Marra*
Affiliation:
Center for Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans’Affairs Health Care System, Iowa City, Iowa, United States University of Iowa Carver College of Medicine, Iowa City, Iowa, United States Division of Medical Practice, Hospital Israelita Albert Einstein, São Paulo, Brazil
Mireia Puig-Asensio
Affiliation:
Center for Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans’Affairs Health Care System, Iowa City, Iowa, United States University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
Erin Balkenende
Affiliation:
Center for Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans’Affairs Health Care System, Iowa City, Iowa, United States University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
Daniel J. Livorsi
Affiliation:
Center for Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans’Affairs Health Care System, Iowa City, Iowa, United States University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
Michihiko Goto
Affiliation:
Center for Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans’Affairs Health Care System, Iowa City, Iowa, United States University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
Eli N. Perencevich
Affiliation:
Center for Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans’Affairs Health Care System, Iowa City, Iowa, United States University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
*
Author for correspondence: Alexandre R. Marra E-mail: alexandre-rodriguesmarra@uiowa.edu

Abstract

Background:

We performed a systematic literature review and meta-analysis measuring the burden of antibiotic use during end-of-life (EOL) care.

Methods:

We searched PubMed, CINAHL (EBSCO platform), and Embase (Elsevier platform), through July 2019 for studies with the following inclusion criteria in the initial analysis: antibiotic use in the EOL care patients (advanced dementia, cancer, organ failure, frailty or multi-morbidity). If the number of patients in palliative care consultation (PCC) was available, antibiotic use data were pooled to compare the proportion of patients who received antibiotics under PCC compared to those not receiving PCC. Random-effect models were used to obtain pooled mean differences, and heterogeneity was assessed using the I2 value.

Results:

Overall, 72 studies met the inclusion criteria and were included in the final review: 22 EOL studies included only patients with cancer; 17 studies included only patients with advanced dementia; and 33 studies included “mixed populations” of EOL patients. Although few studies reported antibiotic using standard metrics (eg, days of therapy), 48 of 72 studies (66.7%) reported antibiotic use in >50% of all patients. When the 3 studies that evaluated antibiotic use in PCC were pooled together, patients under PCC was more likely to receive antibiotics compared to patients not under PCC (pooled odds ratio, 1.73; 95% CI, 1.02–2.93).

Conclusions:

Future studies are needed to evaluate the benefits and harms of using antibiotics for patients during EOL care in diverse patient populations.

Type
Original Article
Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

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References

End-of-life care. Caresearch Palliative Care Knowledge Network website. www.caresearch.com.au/caresearch/tabid/738/Default.aspx. Accessed January 10, 2019.Google Scholar
Thomas, K, Armstrong-Wilson, J, GSF Team. End of life care. Gold Standards Framework website. http://www.goldstandardsframework.org.uk/PIG. Puiblished 2016. Accessed January 8, 2019.Google Scholar
National consensus statement: essential elements for safe and high-quality end-of-life care. Australian Commission on Safety and Quality in Health Care website. https://www.safetyandquality.gov.au/publications-and-resources/resource-library/national-consensus-statement-essential-elements-safe-and-high-quality-end-life-care. Published 2015. Accessed January 10, 2020.Google Scholar
National cancer control programs: policies and managerial guidelines. World Health Organization http://apps.who.int/iris/bitstream/10665/42494/1/9241545577.pdf. Published 2002. Accessed January 10, 2020.Google Scholar
Schoenherr, LA, Bischoff, KE, Marks, AK, O’Riordan, DL, Pantilat, SZ. Trends in hospital-based specialty palliative care in the United States From 2013 to 2017. JAMA Netw Open 2019;2:e1917043.CrossRefGoogle ScholarPubMed
Macedo, F, Nunes, C, Ladeira, K, et al. Antimicrobial therapy in palliative care: an overview. Support Care Cancer 2018;26:13611367.CrossRefGoogle ScholarPubMed
Rosenberg, JH, Albrecht, JS, Fromme, EK, et al. Antimicrobial use for symptom Management in patients receiving hospice and palliative care: a systematic review. J Palliat Med 2013;16:15681574.CrossRefGoogle ScholarPubMed
Juthani-Mehta, M, Allore, HG. Design and analysis of longitudinal trials of antimicrobial use at the end of life: to give or not to give? Ther Adv Drug Saf 2019. doi: 10.1177/2042098618820210.CrossRefGoogle ScholarPubMed
Barlam, TF, Cosgrove, SE, Abbo, LM, et al. Implementing an antibiotic stewardship program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis 2016;62(10):e51e77.CrossRefGoogle Scholar
Liberati, A, Altman, DG, Tetzlaff, J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009;339:b2700.CrossRefGoogle ScholarPubMed
Stroup, DF, Berlin, JA, Morton, SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 2000;283:20082012.CrossRefGoogle ScholarPubMed
Downs, SH, Black, N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomized and non-randomised studies of healthcare interventions. J Epidemiol Commun Health 1998; 52:377384.CrossRefGoogle Scholar
Alderson, PGS, Higgins, JPT, editors. Assessment of study quality. Cochrane Reviewer’s Handbook, version 4.2.3. Chichester, UK: John Wiley & Sons; 2004.Google Scholar
DerSimonian, R, Laird, N. Meta-analysis in clinical trials. Control Clin Trials 1986;7:177188.CrossRefGoogle ScholarPubMed
Al-Shaqi, MA, Alami, AH, Zahrani, AS, et al. The pattern of antimicrobial use for palliative care in-patients during the last week of life. Am J Hosp Palliat Care 2012;29:6063.CrossRefGoogle Scholar
Azad, AA, Siow, SF, Tafreshi, A, Moran, J, Franco, M. Discharge patterns, survival outcomes, and changes in clinical management of hospitalized adult patients with cancer with a do-not-resuscitate order. J Palliat Med 2014;17:776781.CrossRefGoogle ScholarPubMed
Baek, SK, Chang, HJ, Byun, JM, Han, JJ, Heo, DS. The association between end-of-life care and the time interval between provision of a do-not-resuscitate consent and death in cancer patients in Korea. Cancer Res Treat 2017;49:502508.CrossRefGoogle ScholarPubMed
Datta, R, Zhu, M, Han, L, Allore, H, Quagliarello, V, Juthani-Mehta, M. Increased length of stay associated with antibiotic use in older adults with advanced cancer transitioned to comfort measures. Am J Hosp Palliat Care 2020;37:2733.CrossRefGoogle ScholarPubMed
Fombuena Moreno, M, Espinar Cid, V. Tratamiento antibiótico en pacientes oncológicos terminales. Experiencia de un Unidad de Cuidados Paliativos. Med Pal 2005;12:152158.Google Scholar
Gao, W, Spicer, JF, Higginson, I. Antibiotic prescribing in primary care for end-of-life cancer patients. J Clin Oncol 2013;31 suppl 15:96279627.CrossRefGoogle Scholar
Girmenia, C, Moleti, ML, Cartoni, C, et al. Management of infective complications in patients with advanced hematologic malignancies in home care. Leukemia 1997;11:18071812.CrossRefGoogle ScholarPubMed
Helde-Frankling, M, Bergqvist, J, Bergman, P, Björkhem-Bergman, L. Antibiotic treatment in end-of-life cancer patients: a retrospective observational study at a palliative care center in Sweden. Cancers (Basel) 2016;8(9):pii:E84.CrossRefGoogle Scholar
Homsi, J, Walsh, D, Panta, R, Lagman, R, Nelson, KA, Longworth, DL. Infectious complications of advanced cancer. Support Care Cancer 2000;8:487492.Google ScholarPubMed
Lam, PT, Chan, KS, Tse, CY, Leung, MW. Retrospective analysis of antibiotic use and survival in advanced cancer patients with infections. J Pain Symptom Manage 2005;30:536543.CrossRefGoogle ScholarPubMed
Lin, CY, Lin, WC, Huang, WT, Feng, YH, Tsao, CJ. Analysis of infection and antibiotics use in terminal cancer patients in a hospice ward in southern Taiwan. J Cancer Res Pract 2012;28:5767.Google Scholar
Mirhosseini, M, Oneschuk, D, Hunter, B, Hanson, J, Quan, H, Amigo, P. The role of antibiotics in the management of infection-related symptoms in advanced cancer patients. J Palliat Care 2006;22:6974.CrossRefGoogle ScholarPubMed
Mohammed, AA, Al-Zahrani, AS, Sherisher, MA, Alnagar, AA, El-Shentenawy, A, El-Kashif, AT. The pattern of infection and antibiotics use in terminal cancer patients. J Egypt Natl Cancer Inst 2014;26:147152.CrossRefGoogle ScholarPubMed
Oh, DY, Kim, JH, Kim, DW, et al. Antibiotic use during the last days of life in cancer patients. Eur J Cancer Care (Engl) 2006;15:7479.CrossRefGoogle ScholarPubMed
Oneschuk, D, Fainsinger, R, Demoissac, D. Antibiotic use in the last week of life in three different palliative care settings. J Palliat Care 2002;18:2528.CrossRefGoogle ScholarPubMed
Pahole, J, Červek, J, Žnidarič, T, Toplak, M, Zavratnik, B, Červek, M. Quality of end-of-life care of patients with lymphoma: a retrospective analysis. Abstracts of the Ninth World Research Congress of the European Association for Palliative Care (EAPC). Palliat Med 2016;217.Google Scholar
Pereira, J, Watanabe, S, Wolch, G. A retrospective review of the frequency of infections and patterns of antibiotic utilization on a palliative care unit. J Pain Symptom Manage 1998;16:374381.CrossRefGoogle ScholarPubMed
Porta, E, Rizzi, B, Lonati, G, De Luca, B, Cattaneo, D. Antimicrobial treatment in hospice: which and when? Support Care Cancer 2009;17:8571039.Google Scholar
Reinbolt, RE, Shenk, AM, White, PH, Navari, RM. Symptomatic treatment of infections in patients with advanced cancer receiving hospice care. J Pain Symptom Manage 2005;30:175182.CrossRefGoogle ScholarPubMed
Schur, S, Masel, EK, Nemecek, R, Watzke, H, Pirker, R. Palliative care unit in the management of patients with advanced lung cancer—the experience of the medical university of Vienna. J Thoracic Oncol 2013;8 suppl 2:S1023S1023.Google Scholar
Thompson, AJ, Silveira, MJ, Vitale, CA, Malani, PN. Antimicrobial use at the end of life among hospitalized patients with advanced cancer. Am J Hosp Palliat Care 2012;29:599603.CrossRefGoogle ScholarPubMed
White, PH, Kuhlenschmidt, HL, Vancura, BG, Navari, RM. Antimicrobial use in patients with advanced cancer receiving hospice care. J Pain Symptom Manage 2003;25:438443.CrossRefGoogle ScholarPubMed
Ahronheim, JC, Morrison, RS, Morris, J, Baskin, S, Meier, DE. Palliative care in advanced dementia: a randomized controlled trial and descriptive analysis. J Palliat Med 2000;3:265273.CrossRefGoogle ScholarPubMed
Catic, AG, Berg, AI, Moran, JA, et al. Preliminary data from an advanced dementia consult service: integrating research, education, and clinical expertise. J Am Geriatr Soc 2013;61:20082012.CrossRefGoogle ScholarPubMed
Chen, JH, Lamberg, JL, Chen, YC, et al. Occurrence and treatment of suspected pneumonia in long-term care residents dying with advanced dementia. J Am Geriatr Soc 2006;54:290295.CrossRefGoogle ScholarPubMed
D’Agata, E, Mitchell, SL. Patterns of antimicrobial use among nursing home residents with advanced dementia. Arch Intern Med 2008;168:357362.CrossRefGoogle ScholarPubMed
D’Agata, E, Loeb, MB, Mitchell, SL. Challenges in assessing nursing home residents with advanced dementia for suspected urinary tract infections. J Am Geriatr Soc 2013;61:6266.Google ScholarPubMed
Di Giulio, P, Toscani, F, Villani, D, Brunelli, C, Gentile, S, Spadin, P. Dying with advanced dementia in long-term care geriatric institutions: a retrospective study. J Palliat Med 2008;11:10231028.CrossRefGoogle ScholarPubMed
Evers, MM, Purohit, D, Perl, D, Khan, K, Marin, DB. Palliative and aggressive end-of-life care for patients with dementia. Psychiatr Serv 2002;53:609613.CrossRefGoogle ScholarPubMed
Fabiszewski, KJ, Volicer, B, Volicer, L. Effect of antibiotic treatment on outcome of fevers in institutionalized Alzheimer’s patients. JAMA 1990;263:31683172.CrossRefGoogle Scholar
Givens, JL, Jones, RN, Shaffer, ML, Kiely, DK, Mitchell, SL. Survival and comfort after treatment of pneumonia in advanced dementia. Arch Intern Med 2010;170:11021107.CrossRefGoogle ScholarPubMed
Hirakawa, Y, Masuda, Y, Kuzuya, M, Kimata, T, Iguchi, A, Uemura, K. End-of-life experience of demented elderly patients at home: findings from DEATH project. Phychogeriatrics 2006;6:6067.CrossRefGoogle Scholar
Klapwijk, MS, Caljouw, MA, van Soest-Poortvliet, MC, van der Steen, JT, Achterberg, WP. Symptoms and treatment when death is expected in dementia patients in long-term care facilities. BMC Geriatr 2014;14:99.CrossRefGoogle ScholarPubMed
Marttini Abarca, J, Carrillo Garcia, P, Oviedo Briones, M, Perdomo Ramirez, B. Palliative care and symptom control at the end of life in very old patients admitted with advanced dementia. Eur Geriatr Med 2017;8 supplement 1:S94.Google Scholar
Mitchell, SL, Shaffer, ML, Loeb, MB, et al. Infection management and multidrug-resistant organisms in nursing home residents with advanced dementia. JAMA Intern Med 2014;174:16601667.CrossRefGoogle ScholarPubMed
Nourhashémi, F, Gillette, S, Cantet, C, et al. End-of life care for persons with advanced Alzheimer’s disease: design and baseline data from the ALFINE study. J Nutr Health Aging 2012;16:457461.CrossRefGoogle ScholarPubMed
van der Steen, JT, Lane, P, Kowall, NW, Knol, DL, Volicer, L. Antibiotics and mortality in patients with lower respiratory infection and advanced dementia. J Am Med Dir Assoc 2012;13:156161.CrossRefGoogle ScholarPubMed
van der Steen, JT, Di Giulio, P, Giunco, F, et al. End of life observatory–prospective study on DEmentia Patients Care (EoLO-PSODEC) Research Group. Pneumonia in nursing home patients with advanced dementia: decisions, intravenous rehydration therapy, and discomfort. Am J Hosp Palliat Care 2018;35:423430.CrossRefGoogle Scholar
Volicer, BJ, Hurley, A, Fabiszewski, KJ, Montgomery, P, Volicer, L. Predicting short-term survival for patients with advanced Alzheimer’s disease. J Am Geriatr Soc 1993;41:535540.CrossRefGoogle ScholarPubMed
Ahronheim, JC, Morrison, RS, Baskin, SA, Morris, J, Meier, DE. Treatment of the dying in the acute care hospital. Advanced dementia and metastatic cancer. Arch Intern Med 1996;156:20942100.CrossRefGoogle ScholarPubMed
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. J Pain Symptom Manage 2013;46:483490.CrossRefGoogle ScholarPubMed
Alonso, A, Ebert, AD, Dörr, D, Buchheidt, D, Hennerici, MG, Szabo, K. End-of-life decisions in acute stroke patients: an observational cohort study. BMC Palliat Care 2016;15:38.CrossRefGoogle Scholar
Arribas, MV, Serrano, AV, Herraiz, CG, et al. Decisiones al final de la vida: suspensión de antibióticos en presencia de infección activa. Rev Esp Geriatr Gerontol 2006;41:297300.CrossRefGoogle Scholar
Bauduer, F, Capdupuy, C, Renoux, M. Characteristics of deaths in a department of oncohaematology within a general hospital: a study of 81 cases. Support Care Cancer 2000;8:302306.CrossRefGoogle Scholar
Brabin, E, Allsopp, L. How effective are parenteral antibiotics in hospice patients? Eur J Palliat Care 2008;15:115117.Google Scholar
Burnham, JP, Chi, S, Ma, J, Dans, MC, Kollef, MH. Reduction in antimicrobial use among medical intensive care unit patients during a cluster randomized crossover trial of palliative care consultation. Infect Control Hosp Epidemiol 2019;40:491492.CrossRefGoogle ScholarPubMed
Choi, YS, Kim, JW, Kim, JE, Kim, EY. Effect of the antibiotics on patient’s quality of life in a palliative care unit of a tertiary teaching hospital. Support Care Cancer 2016;24 suppl 1:S194S194.Google Scholar
Chun, ED, Rodgers, PE, Vitale, CA, Collins, CD, Malani, PN. Antimicrobial use among patients receiving palliative care consultation. Am J Hosp Palliat Care 2010;27:261265.CrossRefGoogle ScholarPubMed
Clayton, J, Fardell, B, Hutton-Potts, J, Webb, D, Chye, R. Parenteral antibiotics in a palliative care unit: prospective analysis of current practice. Palliat Med 2003;17:4448.CrossRefGoogle Scholar
Dagli, O, Tasdemir, E, Ulutasdemir, N. Palliative care infections and antibiotic cost: a vicious circle. Aging Male 2019:18.Google ScholarPubMed
Fins, JJ, Miller, FG, Acres, CA, Bacchetta, MD, Huzzard, LL, Rapkin, BD. End-of-life decision-making in the hospital: current practice and future prospects. J Pain Symptom Manage 1999;17:615.CrossRefGoogle ScholarPubMed
Fong, K, Oravec, M, Radwany, S. Antibiotic use in hospice patients. J Pain Symptom Manage 2017;53:434435.CrossRefGoogle Scholar
Furuno, JP, Noble, BN, Horne, KN, et al. Frequency of outpatient antibiotic prescription on discharge to hospice care. Antimicrob Agents Chemother 2014;58:54735477.CrossRefGoogle ScholarPubMed
Furuno, JP, Noble, BN, Bearden, DT, Fromme, EK. Feasibility of retrospective pharmacovigilance studies in hospice care: a case study of antibiotics for the treatment of urinary tract infections. J Palliat Med 2017;20:316317.CrossRefGoogle ScholarPubMed
Hirakawa, Y, Masuda, Y, Kuzuya, M, Iguchi, A, Asahi, T, Uemura, K. Home end-of-life care for advanced dementia vs advanced cancer elderly patients: dying elderly at home project. Nihon Ronen Igakkai Zasshi 2006;43:355360.CrossRefGoogle ScholarPubMed
Kadoyama, KL, Noble, BN, Izumi, S, et al. Frequency and documentation of medication decisions on discharge from the hospital to hospice care. J Am Geriatr Soc 2019;67:12581262.CrossRefGoogle ScholarPubMed
Koon, OE, Heng, CP. Antibiotic use in the last two weeks of life for home hospice patients in Singapore. Eur J Palliat Care 2016;23:299303.Google Scholar
Low, JA, Yap, KB, Chan, KM, Tang, T. Care of elderly patients with DNR orders in Singapore—a descriptive study. Singapore Med J 1998;39:456460.Google ScholarPubMed
Merel, SE, Meier, CA, McKinney, CM, Pottinger, PS. Antimicrobial use in patients on a comfort care protocol: a retrospective cohort study. J Palliat Med 2016;19:12101214.CrossRefGoogle ScholarPubMed
Niederman, MS, Ornstein, MC. Antibiotics are used excessively in terminally ill ICU patients and create potential harm to others. Am J Respir Crit Care Med 2011;183:A6220.Google Scholar
Niederman, MS. Palliative care consultation facilitates withdrawal of unnecessary antibiotic use in the ICU. Am J Respir Crit Care Med 2012;185:A5211.Google Scholar
Philip, JA, Gold, M, Sutherland, S, et al. End-of-life care in adults with cystic fibrosis. J Palliat Med 2008;11:198203.CrossRefGoogle ScholarPubMed
Phua, J, Kee, AC, Tan, A, et al. End-of-life care in the general wards of a Singaporean hospital: an Asian perspective. J Palliat Med 2011;14:12961301.CrossRefGoogle Scholar
Rajala, K, Lehto, JT, Saarinen, M, Sutinen, E, Saarto, T, Myllärniemi, M. End-of-life care of patients with idiopathic pulmonary fibrosis. BMC Palliat Care 2016;15:85.CrossRefGoogle ScholarPubMed
Reinhardt, JP, Downes, D, Cimarolli, V, Bomba, P. End-of-Life Conversations and hospice placement: association with less aggressive care desired in the nursing home. J Soc Work End Life Palliat Care 2017;13:6181.CrossRefGoogle ScholarPubMed
Robinson, WM, Ravilly, S, Berde, C, Wohl, ME. End-of-life care in cystic fibrosis. Pediatrics 1997;100:205209.CrossRefGoogle ScholarPubMed
Smallwood, N, Bartlett, C, Taverner, J, Le, B, Irving, L, Philip, J. Palliation of patients with chronic obstructive pulmonary disease at the end of life. Respirology 2016;21 suppl 2:143.Google Scholar
Soh, J, Van Der Poel, L, Mcquillan, R, Kennely, SM. Assessment of end of life care (EOLC) outcomes in an Irish nursing home population using a modified version of the physician orders for life-sustaining treatment (POLST) tool. Eur Geriatr Med 2012;3 suppl:S31–S31.CrossRefGoogle Scholar
Tagashira, Y, Kawahara, K, Takamatsu, A, Honda, H. Antimicrobial prescribing in patients with advanced-stage illness in the antimicrobial stewardship era. Infect Control Hosp Epidemiol 2018;39:10231029.CrossRefGoogle ScholarPubMed
Taverner, J, Ross, L, Bartlett, C, Luthe, M, Ong, J, Irving, L, Smallwood, N. Antimicrobial prescription in patients dying from chronic obstructive pulmonary disease. Intern Med J 2019;49:6673.CrossRefGoogle ScholarPubMed
Tiirola, A, Korhonen, T, Surakka, T, Lehto, JT. End-of-life care of patients with amyotrophic lateral sclerosis and other nonmalignant diseases. Am J Hosp Palliat Care 2017;34:154159.CrossRefGoogle ScholarPubMed
Vitetta, L, Kenner, D, Sali, A. Bacterial infections in terminally ill hospice patients. J Pain Symptom Manage 2000;20:326334.CrossRefGoogle ScholarPubMed
Quinn, B, Thomas, K. Using the gold standards framework to deliver good end of life care. Nurs Manag 2017:23:2025.Google ScholarPubMed
Dagli, O, Tasdemir, E, Ulutasdemir, N. Palliative care infections and antibiotic cost: a vicious circle. Aging Male 2019. doi: 10.1080/13685538.2019.1575353.Google ScholarPubMed
Oneschuk, D, Fainsinger, R, Demoissac, D. Antibiotic use in the last week of life in three different palliative care settings. J Palliat Care 2002;18:2528.CrossRefGoogle ScholarPubMed
Kwak, YG, Moon, C, Kim, ES, Kim, BN. Frequent prescription of antibiotics and high burden of antibiotic resistance among deceased patients in general medical wards of acute care hospitals in Korea. PLoS One 2016;11:e0146852.CrossRefGoogle ScholarPubMed
Hua, M, Lu, Y, Ma, X, Morrison, RS, Li, G, Wunsch, H. Association between the implementation of hospital-based palliative care and use of intensive care during terminal hospitalizations. JAMA Netw Open 2020;3:e1918675.CrossRefGoogle ScholarPubMed
Hua, M, Wunsch, H. Placing value on end-of-life care-is it time for a new taxonomy? JAMA Netw Open 2019;2:e1914466.CrossRefGoogle ScholarPubMed
Fried, TR, Bradley, EH, Towle, VR, Allore, H. Understanding the treatment preferences of seriously ill patients. N Engl J Med 2002;346:10611066.CrossRefGoogle ScholarPubMed
Periyakoil, VS, Neri, E, Fong, A, Kraemer, H. Do unto others: doctors’ personal end-of-life resuscitation preferences and their attitudes toward advance directives. PLoS One 2014;9(5):e98246.CrossRefGoogle ScholarPubMed
Wunsch, H, Scales, D, Gershengorn, HB, et al. End-of-life care received by physicians compared with nonphysicians. JAMA Netw Open 2019;2:e197650.CrossRefGoogle ScholarPubMed
Ivo, K, Younsuck, K, Ho, YY, et al. A survey of the perspectives of patients who are seriously ill regarding end-of-life decisions in some medical institutions of Korea, China and Japan. J Med Ethics 2012;38:310316.CrossRefGoogle ScholarPubMed
Yao, CA, Hsieh, MY, Chiu, TY, et al. Wishes of patients with terminal cancer and influencing factors toward the use of antibiotics in Taiwan. Am J Hosp Palliat Care 2015;32:537543.CrossRefGoogle ScholarPubMed
Juthani-Mehta, M, Malani, PN, Mitchell, SL. Antimicrobials at the end of life: an opportunity to improve palliative care and infection management. JAMA 2015;314:20172018.CrossRefGoogle ScholarPubMed
Dowson, L, Friedman, ND, Marshall, C, et al. Antimicrobial stewardship near the end of life in aged care homes. Am J Infect Control 2020;48:688694.CrossRefGoogle ScholarPubMed
Daneman, N, Campitelli, MA, Giannakeas, V, et al. Influences on the start, selection and duration of treatment with antibiotics in long-term care facilities. CMAJ 2017;189:E851E860.CrossRefGoogle ScholarPubMed
Daneman, N, Gruneir, A, Bronskill, SE, et al. Prolonged antibiotic treatment in long-term care: role of the prescriber. JAMA Intern Med 2013;173:673682.CrossRefGoogle ScholarPubMed
Gaw, CE, Hamilton, KW, Gerber, JS, Szymczak, JE. Physician perceptions regarding antimicrobial use in end-of-life care. Infect Control Hosp Epidemiol 2018;39:383390.CrossRefGoogle ScholarPubMed
Harris, AD, Lautenbach, E, Perencevich, E. A systematic review of quasi-experimental study designs in the fields of infection control and antibiotic resistance. Clin Infect Dis 2005;41:7782.Google ScholarPubMed
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Tables S1-S3

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Appendices 1-2

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