Analysis of Infection and Antibiotics Use in Terminal Cancer Patients in a Hospice Ward in Southern Taiwan
摘要
Background: Infection is one of the common problems that occurs in cancer patients, but antibiotic therapy for terminal cancer patients is complicated and remains controversial.Methods: We retrospectively collected medical records from a palliative care ward in southern Taiwan. Data included the prevalence, characteristics, potential risks of infection, and the outcomes after administration of antibiotic prescriptions through final hospital admission prior to patient death.Results: From May 2007 to February 2008, a total of 168 eligible patients were enrolled. There were twice as many males enrolled than females (M/F: 112/56), and the mean age was 64.2 years. Infections were recognized in 115 patients (68.5 %) with a total of 123 infection episodes (once/twice: 107/8). Among those infected patients, 87 patients (75.7 %) had infection upon admission, and 28 patients (24.3 %) had new infection after admission. The most prevalent locations for infection in patients were the respiratory tract, urinary tract and the skin, and Pseudomonas aeruginosa was the most common pathogen. The number of foreign body implantations and nursing care demands were risk factors for infection. Most infections (99.2%) were treated by antibiotics, after which the symptoms of infection improved in 67 patient events (54.9 %); fever and dyspnea relief were the most commonly seen symptoms. The mean duration of hospitalization was significantly longer for infected patients than for uninfected patients (11.95 days vs. 6.87 days, p = .001).Conclusions: Our study revealed that antibiotic therapy provides modest benefits for terminal cancer patients. However, further studies to ascertain the optimal factors as a guide for antibiotic use in infected terminal cancer patients are necessary.