{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:02:36Z","timestamp":1785416556021,"version":"3.56.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T00:00:00Z","timestamp":1680220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Claude D. Pepper Older Americans Independence Center at Yale School of Medicine","award":["P30AG021342"],"award-info":[{"award-number":["P30AG021342"]}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"crossref","award":["2T32AI007517-16"],"award-info":[{"award-number":["2T32AI007517-16"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100019934","name":"Society for Healthcare Epidemiology of America","doi-asserted-by":"publisher","award":["2020 Yoshikawa-High Award"],"award-info":[{"award-number":["2020 Yoshikawa-High Award"]}],"id":[{"id":"10.13039\/100019934","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat Med"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Older adults with advanced cancer are exposed to antibiotics but estimates of adverse drug events associated with antibiotic therapy are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>Evaluate the association of antibiotic therapy with adverse drug events in older adults with advanced cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>\n                      Cohort study where the exposure was the ratio of days of therapy of an oral or intravenous antibiotic per patient-day and the outcome was an adverse drug event, defined as cardiotoxicity, hepatotoxicity, nephrotoxicity,\n                      <jats:italic toggle=\"yes\">Clostridioides difficile<\/jats:italic>\n                      infection, or new detection of a multidrug-resistant organism.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/participants:<\/jats:title>\n                    <jats:p>\n                      Patients aged \u2a7e65\u2009years with solid tumors from a tertiary care center who received palliative chemotherapy (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009914).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Mean age was 75\u2009\u00b1\u20096.6\u2009years, and 52% were female. Common tumors were lung (31%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009284) and gastrointestinal (26%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009234). Mean time from first course of palliative chemotherapy to index admission was 128\u2009days. Five-hundred thirty (58%) patients were exposed to antibiotics during the index admission; of these, 27% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009143) met standardized criteria for infection. Patients were commonly exposed to cephalosporins (33%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009298) and vancomycin (30%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009276). Among patients exposed to antibiotics, 35% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009183\/530) developed an adverse drug event. In multivariable testing, antibiotic therapy was associated with development of an adverse drug event (&gt;0 to &lt;1 vs 0\u2009days of therapy\/patient-day: adjusted odds ratio [aOR]\u2009=\u20091.9; 95% confidence interval [CI], 1.2\u20132.8; \u2a7e1 vs 0\u2009days of therapy\/patient-day: aOR\u2009=\u20092.1, 95% CI, 1.4\u20133.0).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Antibiotic therapy was independently associated with adverse drug events in hospitalized older adults with advanced cancer. These findings may inform antibiotic decision-making among palliative care providers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692163231162889","type":"journal-article","created":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T08:54:11Z","timestamp":1680252851000},"page":"793-798","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Antibiotic therapy is associated with adverse drug events among older adults with advanced cancer: A cohort study"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2281-7508","authenticated-orcid":false,"given":"Rupak","family":"Datta","sequence":"first","affiliation":[{"name":"Hospital Epidemiology and Infection Prevention Program, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA"},{"name":"Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Han","sequence":"additional","affiliation":[{"name":"Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Doyle","sequence":"additional","affiliation":[{"name":"Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Allore","sequence":"additional","affiliation":[{"name":"Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA"},{"name":"Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara","family":"Sanft","sequence":"additional","affiliation":[{"name":"Section of Medical Oncology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Quagliarello","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manisha","family":"Juthani-Mehta","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA"},{"name":"Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,3,31]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.1938"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.2603-18"},{"key":"e_1_3_3_4_2","first-page":"331","article-title":"Reducing the risk of adverse drug events in older adults","volume":"87","author":"Pretorius RW","year":"2013","unstructured":"Pretorius RW, Gataric G, Swedlund SK, et al. 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