Increased Length of Stay Associated With Antibiotic Use in Older Adults With Advanced Cancer Transitioned to Comfort Measures.
Rupak Datta, Mojun Zhu, Ling Han and 3 others
PMID 31185722WHAT IT FOUND
Antibiotic use was associated with 34% longer hospital stay among 461 older adults with advanced cancer moved to comfort care.
Among antibiotic recipients, 94% received intravenous antibiotics, and 40% continued until discharge or death.
Key findings
01Antibiotic use was associated with 34% longer hospital length of stay after accounting for age, gender, cancer type, comorbidities, ICU admission, and infection.
02Of 461 analyzed patients, 382 received antibiotics; 94% of those received intravenous therapy, and the median antibiotic therapy duration was 12 days.
03Among patients who received antibiotics, 40% remained on antibiotics until discharge or death, and antibiotics were stopped a median of 1 day before discharge or death.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a retrospective observational study, so antibiotic use may have been associated with sicker patients or different goals of care rather than causing longer stay. The study did not assess whether antibiotics were appropriate, whether they improved symptoms, or whether patients and families wanted them. Infection was identified using hospital codes, which may misclassify infections. It was done at one hospital, so results may not apply to other settings or hospice care.
The easy way to misread this
Do not read the 34% longer stay as proof that antibiotics caused longer hospitalization. The study was observational, and it did not measure symptom relief, antibiotic appropriateness, or goals of care.