Miranda-Chavez Brayan, Fuentes-Yufra Andre, Hueda-Zavaleta Miguel, Copaja-Corzo Cesar, Flores-Cohaila Javier A, Rivarola-Hidalgo Marco
Facultad de Ciencias de la Salud, Universidad Privada de Tacna, Tacna, Peru.
Centro de Estudios e Investigación en Educación Médica y Bioética. Universidad Privada de Tacna. Tacna, Perú.
Health Serv Insights. 2024 Sep 15;17:11786329241280812. doi: 10.1177/11786329241280812. eCollection 2024.
To identify and analyze antibiotics' prescription patterns and associated factors among terminally ill patients at a hospital in southern Peru.
A cross-sectional analytical study was conducted on adult patients who died in Hospital III Daniel Alcides Carrion in Tacna, Peru, 2023. Data were collected from electronic medical records, focusing on antibiotic use during the last hospitalization. Univariate, bivariate, and multivariate analyses were performed using Poisson regression to adjust for potential confounders.
The study included 239 patients with an average age of 76. Antibiotics were administered to 93.72% of patients, with 42.46% lacking an identified infectious focus. Ceftriaxone, Meropenem, and Vancomycin were the most used antibiotics. A lower use of antibiotics within 72 hours prior to death was associated with hospitalizations longer than 18 days and having 2 or more comorbidities.
The high prevalence of antibiotic use at the end of life, often without an infectious focus, suggests a need for better guidelines and education on palliative care to avoid inappropriate antibiotic prescribing. Improved communication between healthcare providers, patients, and families is essential for optimizing end-of-life care.
识别并分析秘鲁南部一家医院临终患者的抗生素处方模式及相关因素。
对2023年在秘鲁塔克纳市丹尼尔·阿尔西德斯·卡里翁三世医院死亡的成年患者进行了一项横断面分析研究。从电子病历中收集数据，重点关注最后一次住院期间的抗生素使用情况。使用泊松回归进行单变量、双变量和多变量分析，以调整潜在的混杂因素。
该研究纳入了239名平均年龄为76岁的患者。93.72%的患者使用了抗生素，其中42.46%的患者未发现明确的感染病灶。头孢曲松、美罗培南和万古霉素是使用最多的抗生素。死亡前72小时内抗生素使用量较低与住院时间超过18天以及患有2种或更多合并症有关。
临终时抗生素使用率高，且往往没有感染病灶，这表明需要更好的姑息治疗指南和教育，以避免不适当的抗生素处方。医疗服务提供者、患者和家属之间加强沟通对于优化临终关怀至关重要。
