Seham Radhi, Mohammed A Alamri, Abdurrahman A Ksibati, Nadia A Shahda, Abdullaha I Alsuhail, Mustafa Zakkar, Ibrahim Antoun
{"title":"Prevalence and Symptomatic Benefit of Antibiotic Use in End-of-Life Patients in Saudi Arabia: An Observational Cohort Study.","authors":"Seham Radhi, Mohammed A Alamri, Abdurrahman A Ksibati, Nadia A Shahda, Abdullaha I Alsuhail, Mustafa Zakkar, Ibrahim Antoun","doi":"10.1177/08258597251336821","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Antibiotic use in patients with advanced cancer at the end of life (EoL) is common but controversial, with limited evidence on its efficacy in improving symptoms. This study aimed to evaluate the prevalence of antibiotic use during the final 30 days of life in patients with advanced cancer and its impact on symptom improvement within a palliative care setting in Saudi Arabia. <b>Methods:</b> A retrospective cohort study was conducted in the palliative care department of King Fahad Medical City, Riyadh, Saudi Arabia. The study included all advanced cancer patients who received inpatient palliative care and died between January 2022 and March 2023. Medical records data were analyzed to assess infection-related symptoms, antibiotic use, and symptom improvement 3 days (D3) post-diagnosis. <b>Results:</b> A total of 220 patients were included, with a mean age of 61 ± 17 years and a mean palliative performance scale of 37%. Antibiotics were prescribed to 89% of patients, primarily empirically (82%). Piperacillin/tazobactam (53%) and meropenem (17%) were the most commonly used antibiotics. Symptom improvement at D3 was observed in 54% of symptomatic patients (n = 95). Improvements were significant for fever (42% to 15%, <i>P</i> < .001), pain (58% to 37%, <i>P</i> < .001), cough (16% to 7%, <i>P</i> = .004), and shortness of breath (32% to 20%, <i>P</i> = .003). The logistic regression model analysis identified no significant predictors of symptom improvement. <b>Conclusion:</b> Antibiotics are widely used EoL care for advanced cancer patients, but their impact on symptom improvement is modest. The findings underscore the need for judicious antibiotic use, guided by individualized care goals and interdisciplinary collaboration, to optimize symptom management while minimizing unnecessary interventions.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"8258597251336821"},"PeriodicalIF":1.3000,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Palliative Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/08258597251336821","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: Antibiotic use in patients with advanced cancer at the end of life (EoL) is common but controversial, with limited evidence on its efficacy in improving symptoms. This study aimed to evaluate the prevalence of antibiotic use during the final 30 days of life in patients with advanced cancer and its impact on symptom improvement within a palliative care setting in Saudi Arabia. Methods: A retrospective cohort study was conducted in the palliative care department of King Fahad Medical City, Riyadh, Saudi Arabia. The study included all advanced cancer patients who received inpatient palliative care and died between January 2022 and March 2023. Medical records data were analyzed to assess infection-related symptoms, antibiotic use, and symptom improvement 3 days (D3) post-diagnosis. Results: A total of 220 patients were included, with a mean age of 61 ± 17 years and a mean palliative performance scale of 37%. Antibiotics were prescribed to 89% of patients, primarily empirically (82%). Piperacillin/tazobactam (53%) and meropenem (17%) were the most commonly used antibiotics. Symptom improvement at D3 was observed in 54% of symptomatic patients (n = 95). Improvements were significant for fever (42% to 15%, P < .001), pain (58% to 37%, P < .001), cough (16% to 7%, P = .004), and shortness of breath (32% to 20%, P = .003). The logistic regression model analysis identified no significant predictors of symptom improvement. Conclusion: Antibiotics are widely used EoL care for advanced cancer patients, but their impact on symptom improvement is modest. The findings underscore the need for judicious antibiotic use, guided by individualized care goals and interdisciplinary collaboration, to optimize symptom management while minimizing unnecessary interventions.
期刊介绍:
The Journal of Palliative Care is a quarterly, peer-reviewed, international and interdisciplinary forum for practical, critical thought on palliative care and palliative medicine. JPC publishes high-quality original research, opinion papers/commentaries, narrative and humanities works, case reports/case series, and reports on international activities and comparative palliative care.