title: The pattern of infection and antibiotics use in terminal cancer patients.
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.
authors.affiliation: Oncology Center, King Abdullah Medical City-Holy Capital, Saudi Arabia; Medical Oncology Department, Faculty of Medicine, Zagazig University, Egypt. Electronic address: amrallaabdelmoneem@yahoo.com.
authors.forename: Amrallah A
authors.initials: AA
authors.lastname: Mohammed
authors.affiliation: Oncology Center, King Abdullah Medical City-Holy Capital, Saudi Arabia.
authors.forename: Abdullah S
authors.initials: AS
authors.lastname: Al-Zahrani
authors.affiliation: Oncology Center, King Abdullah Medical City-Holy Capital, Saudi Arabia; Medical Oncology Department, National Cancer Institute, Cairo University, Egypt.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Sherisher
authors.affiliation: Oncology Center, King Abdullah Medical City-Holy Capital, Saudi Arabia; Medical Oncology Department, Faculty of Medicine, Zagazig University, Egypt.
authors.forename: Ahmad A
authors.initials: AA
authors.lastname: Alnagar
authors.affiliation: Oncology Center, King Abdullah Medical City-Holy Capital, Saudi Arabia; Clinical Oncology Department, Faculty of Medicine, Cairo University, Egypt.
authors.forename: Ayman
authors.initials: A
authors.lastname: El-Shentenawy
authors.affiliation: Oncology Center, King Abdullah Medical City-Holy Capital, Saudi Arabia; Clinical Oncology Department, Faculty of Medicine, Cairo University, Egypt.
authors.forename: Amr T
authors.initials: AT
authors.lastname: El-Kashif
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007239:Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D012189:Retrospective Studies; D013727:Terminal Care; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; Infection; Terminal cancer