Amrallah A Mohammed1, Abdullah S Al-Zahrani2, Mohamed A Sherisher3, Ahmad A Alnagar4, Ayman El-Shentenawy5, Amr T El-Kashif5. 1. Oncology Center, King Abdullah Medical City-Holy Capital, Saudi Arabia; Medical Oncology Department, Faculty of Medicine, Zagazig University, Egypt. Electronic address: amrallaabdelmoneem@yahoo.com. 2. Oncology Center, King Abdullah Medical City-Holy Capital, Saudi Arabia. 3. Oncology Center, King Abdullah Medical City-Holy Capital, Saudi Arabia; Medical Oncology Department, National Cancer Institute, Cairo University, Egypt. 4. Oncology Center, King Abdullah Medical City-Holy Capital, Saudi Arabia; Medical Oncology Department, Faculty of Medicine, Zagazig University, Egypt. 5. Oncology Center, King Abdullah Medical City-Holy Capital, Saudi Arabia; Clinical Oncology Department, Faculty of Medicine, Cairo University, Egypt.
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 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.
BACKGROUND: Although cancerpatients 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 cancerpatients 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 infectedpatients 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 cancerpatients should be on a clear rationale. We need further study to clarify if there is survival effect with antibiotic use or not.