The pattern of infection and antibiotics use in terminal cancer patients

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 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. © 2014.