Antibiotic use during the last days of life in cancer patients
Antibiotic use during the last days of life in cancer patients
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DOI：
10.1111/j.1365-2354.2005.00603.x
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发表时间：
2006-03-01
影响因子：
2.1
通讯作者：
Kim, NK
中科院分区：
文献类型：
--
作者：
Oh, DY;Kim, JH;Kim, NK
本研究的目的是记录感染，并更好地了解目前与抗生素使用及其对晚期癌症患者的影响有关的实践。我们回顾性分析了2003年3月至2004年4月间因症状控制而入住首尔国立大学宝来美医院的晚期癌症患者。共入组141例患者。从入院到死亡的平均时间为31.2天。共有104例患者（75.2%）发生发热事件，医生认为113例患者（80.1%）发生临床感染。共119例（84.4%）患者使用抗生素。90例患者（63.8%）使用抗生素直至死亡。在使用抗生素后，48%的发烧得到控制，31%的经微生物证实的病例得到解决。感染症状改善18例（15.1%），无改善66例（55.4%）。白细胞增加17%，C反应蛋白升高29%。总之，我们的研究揭示了癌症患者在生命的最后一个月内的高感染率和高抗生素处方率。但超过一半的患者症状没有改善。应进行进一步的研究，以阐明抗生素在晚期癌症患者中的益处。
The purpose of this study is to document infection and to better understand current practice relating to antibiotic use and its effect in terminal cancer patients. We retrospectively reviewed patients with terminal stage cancer who were admitted to Seoul National University Boramae Hospital for symptom control only, and who finally died between March 2003 and April 2004. A total of 141 patients were enrolled. Mean duration from admission to death was 31.2 days. A total of 104 patients (75.2%) experienced a febrile episode, and physicians considered 113 patients (80.1%) developed a clinical infection. Total 119 patients (84.4%) received antibiotics. For 90 patients (63.8%), antibiotics were used until the day of death. After using antibiotics, 48% of fevers were controlled, and 31% of organism-proven cases were resolved. Symptomatic improvement of infection was achieved in 18 patients (15.1%), but 66 patients (55.4%) showed no improvement. Improved leucocytosis was achieved by 17% and C Reactive Protein elevation by 29%. In conclusion, our study reveals a high rate of infection and a high rate of antibiotic prescription during the last month of life in cancer patients. But symptomatic improvement was not achieved in more than half of the patients. Further study should be undertaken to clarify the benefit of antibiotics in terminal stage cancer patients.