The Role of Antibiotics Use in Terminal Cancer Patients

Abstract

Background: Infections are the leading cause of death in cancer patients. Despite the high infection rate and frequent use of antibiotics in palliative wards, there is no consensus for antibiotics prescription in this setting currently. Objective: To investigate the relation of antibiotics use and the survival time in palliative settings. Methods: We retrospectively reviewed medical charts of cancer patients admitted to the hospice ward in a medical center of middle Taiwan. The presence of infections was identified by symptoms and signs in medical records, with or without microbial investigations. Results: A total of 116 patients were included in the study. The most frequent primary sites of malignancies were lung and bronchus, gastrointestinal tract and mouth cavity. There were 77 patients with totally 94 infection episodes diagnosed. Two thirds of them were pneumonia and urinary tract infections. There were 39 positive results of 109 cultures performed in 65 patients. 47 organisms were isolated. Pseudomonas and Klebsiella pneumoniae were the most common pathogens therein. 67 patients with 80 infection episodes were treated with antibiotics. There was no significant difference of overall survivals between infected and uninfected groups. Among the infected patients, post-infection survivals between those treated with antibiotics and left untreated were not significantly different, after exclusion of pre-dying patients. Although most of the patients received antibiotics intravenously, their post-infection survival did not significantly differ from those with oral antibiotics only. Conclusion: Our study concluded that in infected terminal cancer patients, the use of antibiotics could not prolong their lives.