BACKGROUND: We sought to evaluate antimicrobial use among patients with advanced cancer. METHODS: Retrospective review of patients experiencing cancer-related death while hospitalized. RESULTS: Among 145 patients, 126 (86.9%) received antimicrobials for a mean of 12.5 ± 12.9 days. 88 (69.8%) of 126 had clinical findings suggestive of infection. Sixty-one patients (48.4%) had positive cultures, the remaining were treated empirically. "Comfort care" was ultimately pursued in 99 (78.5%) of 126; 35 (35.4%) of 99 continued to receive antimicrobials after a transition to comfort care for an average of 1.6 ± 1.1 days. On average, antimicrobials were discontinued <1day prior to death. CONCLUSION: Antimicrobial use was common among patients with advanced cancer. Even after transition to comfort care, more than one third of patients remained on antimicrobials. The risks and burdens of antimicrobials should be carefully examined when comfort is the stated goal.
BACKGROUND: We sought to evaluate antimicrobial use among patients with advanced cancer. METHODS: Retrospective review of patients experiencing cancer-related death while hospitalized. RESULTS: Among 145 patients, 126 (86.9%) received antimicrobials for a mean of 12.5 ± 12.9 days. 88 (69.8%) of 126 had clinical findings suggestive of infection. Sixty-one patients (48.4%) had positive cultures, the remaining were treated empirically. "Comfort care" was ultimately pursued in 99 (78.5%) of 126; 35 (35.4%) of 99 continued to receive antimicrobials after a transition to comfort care for an average of 1.6 ± 1.1 days. On average, antimicrobials were discontinued <1day prior to death. CONCLUSION: Antimicrobial use was common among patients with advanced cancer. Even after transition to comfort care, more than one third of patients remained on antimicrobials. The risks and burdens of antimicrobials should be carefully examined when comfort is the stated goal.
Authors: Jason P Burnham; Stephen Chi; Jessica Ma; Maria C Dans; Marin H Kollef Journal: Infect Control Hosp Epidemiol Date: 2019-03-06 Impact factor: 3.254
Authors: Tamar F Barlam; Sara E Cosgrove; Lilian M Abbo; Conan MacDougall; Audrey N Schuetz; Edward J Septimus; Arjun Srinivasan; Timothy H Dellit; Yngve T Falck-Ytter; Neil O Fishman; Cindy W Hamilton; Timothy C Jenkins; Pamela A Lipsett; Preeti N Malani; Larissa S May; Gregory J Moran; Melinda M Neuhauser; Jason G Newland; Christopher A Ohl; Matthew H Samore; Susan K Seo; Kavita K Trivedi Journal: Clin Infect Dis Date: 2016-04-13 Impact factor: 9.079
Authors: Alexandre E Nowill; Márcia C Fornazin; Maria C Spago; Vicente Dorgan Neto; Vitória R P Pinheiro; Simônia S S Alexandre; Edgar O Moraes; Gustavo H M F Souza; Marcos N Eberlin; Lygia A Marques; Eduardo C Meurer; Gilberto C Franchi; Pedro O de Campos-Lima Journal: J Immunol Date: 2019-07-29 Impact factor: 5.422
Authors: Jon P Furuno; Brie N Noble; Kristi N Horne; Jessina C McGregor; Miriam R Elman; David T Bearden; Eric W Walsh; Erik K Fromme Journal: Antimicrob Agents Chemother Date: 2014-07-07 Impact factor: 5.191
Authors: Ronald T C M van Nordennen; Jan C M Lavrijsen; Kris C P Vissers; Raymond T C M Koopmans Journal: Drugs Aging Date: 2014-07 Impact factor: 3.923