P0013 The pattern of infection and antibiotic use in terminal cancer patients

Abstract

Background Although cancer patients are susceptible to infection, there is no evidence-based published guideline on the appropriate use of antimicrobial treatment in this group of patients. Methods We retrospectively collected medical records of all terminally ill cancer patients who died in hospital over a 15-month period. We recorded demographics and the frequency and rationale of antimicrobial use during the patients’ last hospital admission before they died. Findings A total of 258 eligible patients were enrolled; there was equal distribution between men and women (129 of each sex), and the mean age was 60.5 years. 221 patients (85%) were admitted with fever, 22 patients (8.5%) got fever after hospitalisation, 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 were positive in 98 patients (40%), and Gram-negative organisms were dominant. The major infection sites were the respiratory tract, urinary tract, and wound sites. 114 patients (47%) received one antibiotic and 129 patients (53%) received more than one. The mean duration of hospitalisation was significantly longer for infected patients than for uninfected patients (8.00 days vs 18.15 days; p = 0.0001). Results of antibiotic use revealed that 42 patients (17.3%) had improved symptoms, 71 patients (29.2%) had no change in symptoms, and 130 patients (53.5%) had symptom deterioration. Interpretation Our study revealed that antibiotic therapy has minimal benefits for terminal cancer patients and the initiation of antibiotics should be based on clear rationale.