The pattern of infection and antibiotics use in terminal cancer patients

J Egypt Natl Canc Inst. 2014 Sep;26(3):147-52. doi: 10.1016/j.jnci.2014.05.002. Epub 2014 Jun 11.


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.

Keywords: Antibiotics; Infection; Terminal cancer.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Female
  • Humans
  • Infections / diagnosis
  • Infections / drug therapy*
  • Infections / etiology*
  • Length of Stay
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Retrospective Studies
  • Terminal Care*
  • Treatment Outcome


  • Anti-Bacterial Agents