C Shekhar Aditya
Center for Bioethics, Harvard Medical School, Boston, MA, USA.
The University of Minnesota - Twin Cities, Minneapolis, MN, USA.
J Hosp Palliat Care. 2022 Mar 1;25(1):50-54. doi: 10.14475/jhpc.2022.25.1.50.
Antibiotics are commonly prescribed medications in the hospice and palliative care setting, as well as in many other healthcare settings. The overuse or negligent use of antibiotics is associated with the harmful consequence of fostering the development of antibiotic-resistant pathogens. Thus, there is an urgent need to critically examine and audit antibiotic use in all aspects of healthcare. In the status quo, there is a lack of consistent standards and guidelines surrounding the use of antibiotics in hospice and palliative care settings, leading to significant variations in how antibiotics are prescribed and administered in end-of-life care. It is apparent that greater thought needs to go into antibiotic decisions for patients receiving hospice or palliative care, especially considering the harmful consequences of the overprescription of antibiotics. The literature suggests that many clinicians prescribe antibiotics inappropriately for patients who would not benefit from their use or prescribe them without adequate documentation. Clinicians should be deliberate about when they prescribe antibiotics and adhere to the appropriate documentation standards and procedures within their institution or community. Future research should seek to generate generalizable knowledge about which patients will benefit most from antibiotic therapy during end-of-life care.
抗生素是临终关怀和姑息治疗环境以及许多其他医疗环境中常用的处方药。抗生素的过度使用或不当使用会产生有害后果，即促使耐药病原体的产生。因此，迫切需要严格审查和审核医疗保健各方面的抗生素使用情况。目前，临终关怀和姑息治疗环境中抗生素使用缺乏统一的标准和指南，导致临终护理中抗生素的处方和使用方式存在显著差异。显然，对于接受临终关怀或姑息治疗的患者，在做出抗生素决策时需要更多思考，尤其是考虑到抗生素过度处方的有害后果。文献表明，许多临床医生会给无法从抗生素使用中获益的患者不恰当地开具抗生素，或者在没有充分记录的情况下开具抗生素。临床医生在开具抗生素时应深思熟虑，并遵守所在机构或社区的适当记录标准和程序。未来的研究应致力于生成关于哪些患者在临终护理期间最能从抗生素治疗中获益的可推广知识。
