Broad-Spectrum Antibiotic Use at the End of Life in Patients With Advanced Cancer

This nationwide South Korean cohort study (2002–2021) examined broad-spectrum antibiotic use among 515,366 patients with advanced cancer in their last six months of life. More than half (55.9%) received at least one broad-spectrum antibiotic. Use peaked at 3–1 months before death (28.1%), while overall antibiotic consumption was highest 1 month to 2 weeks before death (190 days of therapy per 1000 patient-days), then declined during the final week (13.3%). Patterns were consistent across cancers and antibiotic classes, though patients with leukemia had the highest late-life exposure.

Conclusion: Broad-spectrum antibiotic use intensifies in the last 3 months, especially 1 month–2 weeks before death, highlighting a critical window to optimize prescribing and better align treatment with end-of-life care goals.