title: The role of antibiotics in the management of infection-related symptoms in advanced cancer patients.
abstract: We prospectively evaluated the effect of antibiotic treatment on infection-related symptoms in patients with advanced cancer, in addition to assessing infection characteristics.
  
  
  METHODS
  A questionnaire was completed for enrolled patients using a personal digital assistant. Pre-antibiotic and post-antibiotic treatment Edmonton Symptom Assessment Scale (ESAS) scores were evaluated. Patient and the patient's physician identified infection-related symptoms experienced by the patient, which were documented under the "other" category on the ESAS. Pre-antibiotic and post-antibiotic scores of the patient and physician for the identified infection-related symptoms were evaluated.
  
  
  RESULTS
  Twenty-six patients on a tertiary palliative care unit with 31 episodes of infection were included for analysis. Patients' pre- and post-antibiotic ESAS scores revealed a small improvement in all variables except anxiety. Patient assessment of symptoms related to infection showed a small improvement in all symptoms, with dsyuria being statistically significant. Physician assessment revealed a slight improvement for all the symptoms, although only cough was statistically significant. A general comparative physician assessment of patient outcome following antibiotic treatment suggested symptom improvement in 48.4% of patients. However, 50% of patients died within a week of antibiotic discontinuation.
  
  
  CONCLUSIONS
  Antibiotic treatment appears to offer a mild improvement in infection-related symptoms. Patients reported the greatest improvement in dysuria, and physicians, in cough. Despite this symptomatic improvement, one quarter of the patients died within one week of antibiotic administration. Further comparative studies to evaluate symptomatic benefit, patient burden, and cost/benefit of antibiotic therapy in the treatment of infections in advanced cancer patients are required.
authors.affiliation: Edmonton Palliative Care Program, Edmonton, Alberta, Canada.
authors.forename: Mehrnoush
authors.initials: M
authors.lastname: Mirhosseini
authors.forename: Doreen
authors.initials: D
authors.lastname: Oneschuk
authors.forename: Brad
authors.initials: B
authors.lastname: Hunter
authors.forename: John
authors.initials: J
authors.lastname: Hanson
authors.forename: Hue
authors.initials: H
authors.lastname: Quan
authors.forename: Pablo
authors.initials: P
authors.lastname: Amigo
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000188:drug therapy / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D017053:Infection Control / Q000191:economics / Q000379:methods; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D009369:Neoplasms / Q000150:complications*; D010166:Palliative Care / Q000191:economics / Q000379:methods; D018579:Patient Selection; D011446:Prospective Studies; D036301:Qualitative Research; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents