The pattern of infection and antibiotics use in terminal cancer patients

Abstract EN

Background : Although cancer patients are susceptible to infection, there is no evidencebased published guideline on the appropriate use of antimicrobial treatment in this group of patients.

Methods : We retrospectively collected medical records of all terminal cancer patients who died in the oncology department over a 15-month period and were reviewed for the pattern of infection and causes of antimicrobial use during the patients’ last admission of life.

Results : A total of 258 eligible patients were enrolled, there was an equal distribution of males and females (M / F : 129 / 129), and the mean age was 60.5 years.

221 patients admitted with fever (85 %), 22 patients (8.5 %) got fever after hospitalization and 15 patients (5.8 %) did not suffer from fever.

Among patients with fever, 46 patients (18.9 %) had two infection episodes and 197 patients (81.1 %) had only one infection episode.

The culture results revealed positive in 98 patients (40 %) with gram-negative organisms were the dominant organisms.

The major infection sites were the respiratory tract, urinary tract and wound.

114 patients (47 %) received one antibiotic and 129 patients (53 %) received more than one.

The mean duration of hospitalization was significantly longer for infected patients than for uninfected patients (8.00 vs.

18.15 days, p = 0.0001).

Outcome of antibiotic use revealed 42 patients (17.3 %) with symptoms improved 71 patients (29.2 %) with stationary symptoms and 130 patients (53.5 %) revealed symptom deterioration.

Conclusions : Our study revealed that antibiotic therapy for terminal cancer patients should be on a clear rationale.

We need further study to clarify if there is survival effect with antibiotic use or not.