Antibiotic Treatment in End-of-Life Cancer Patients-A Retrospective Observational Study at a Palliative Care Center in Sweden.
BACKGROUND
The aim of this study was to elucidate whether palliative cancer patients benefit from antibiotic treatment in the last two weeks of life when an infection is suspected.


METHODS
We reviewed medical records from 160 deceased palliative cancer patients that had been included in previous studies on vitamin D and infections. Patients treated with antibiotics during the last two weeks of life were identified and net effects of treatment (symptom relief) and possible adverse events were extracted from medical records.


RESULTS
Seventy-nine patients (49%) had been treated with antibiotics during the last two weeks in life. In 37% (n = 29), the treatment resulted in evident symptom relief and among these 50% had a positive bacterial culture, 43% had a negative culture and in 7% no culture was taken. Among the patients with no or unknown effect of antibiotics, 50% had a positive culture. When the indication for antibiotic treatment was to avoid or treat sepsis, symptom relief was achieved in 50% of the patients (n = 19). Only 4% (n = 3) of the patients experienced adverse events of the treatment (diarrhea, nausea).


CONCLUSIONS
Treating infections with antibiotics in the last weeks of life may improve the quality of life for palliative cancer patients, especially if sepsis is suspected or confirmed. According to our results, the beneficial effects outweigh the potentially negative outcomes.
ASIH Stockholm Södra, Långbro Park, Palliative Home Care and Hospice Ward, Bergtallsvägen 12, 125 59 Älvsjö, Sweden. maria.helde-frankling@sll.se.|Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet and Karolinska University Hospital, Huddinge, 141 86 Stockholm, Sweden. maria.helde-frankling@sll.se.
Maria
M
Helde-Frankling
Breast Centre, Department of Surgery, Capio St. Gorans Hospital, 112 81 Stockholm, Sweden. Jenny.Bergqvist@capiostgoran.se.|Department of Oncology/Pathology, Karolinska Institutet, 171 77 Stockholm, Sweden. Jenny.Bergqvist@capiostgoran.se.
Jenny
J
Bergqvist
Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet and Karolinska University Hospital, Huddinge, 141 86 Stockholm, Sweden. peter.bergman@ki.se.
Peter
P
Bergman
ASIH Stockholm Södra, Långbro Park, Palliative Home Care and Hospice Ward, Bergtallsvägen 12, 125 59 Älvsjö, Sweden. linda.bjorkhem-bergman@ki.se.|Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet and Karolinska University Hospital, Huddinge, 141 86 Stockholm, Sweden. linda.bjorkhem-bergman@ki.se.
Linda
L
Björkhem-Bergman
CRP; antibiotics; cancer; hospice care; immune system; infections; palliative care; vitamin D