Antimicrobial use at the end of life among hospitalized patients with advanced cancer.
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.


CONCLUSIONS
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.
Department of Internal Medicine Divisions of Infectious Diseases, University of Michigan Medical School, Ann Arbor, MI, USA.
Andrew J
AJ
Thompson
Maria J
MJ
Silveira
Caroline A
CA
Vitale
Preeti N
PN
Malani
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D010166:Palliative Care / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013727:Terminal Care / Q000706:statistics & numerical data*
D000900:Anti-Bacterial Agents