Antibiotic use towards the end of life: development of good practice recommendations
Objectives Development of evidence-based good practice recommendations for clinicians considering the use of antibiotics in patients towards the end of life. Design A multiprofessional group of experts in end-of-life care and antimicrobial stewardship was convened. Findings from a scoping review of the literature and a consultation of clinicians were triangulated. Expert discussion was used to generate consensus on how to approach decision-making. Setting Representatives from hospital and a range of community health and care settings. Participants Medical, pharmacy and nursing professionals. Main outcome measures Good practice recommendations based on published evidence and the experience of prescribers in Scotland. Results The findings of 88 uncontrolled, observational studies of variable quality were considered alongside a survey of over 200 prescribers. No national or international guidelines were identified. Antibiotic use towards the end of life was common but practice was highly