Prevalence and Symptomatic Benefit of Antibiotic Use in End-of-Life Patients in Saudi Arabia: An Observational Cohort Study.

IF 1.3 4区 医学 Q4 HEALTH CARE SCIENCES & SERVICES
Seham Radhi, Mohammed A Alamri, Abdurrahman A Ksibati, Nadia A Shahda, Abdullaha I Alsuhail, Mustafa Zakkar, Ibrahim Antoun
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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.

沙特阿拉伯临终患者使用抗生素的患病率和症状获益:一项观察性队列研究。
目的:晚期癌症患者在生命末期(EoL)使用抗生素是常见的,但存在争议,关于其改善症状的有效性的证据有限。本研究旨在评估沙特阿拉伯姑息治疗环境下晚期癌症患者生命最后30天内抗生素使用的流行程度及其对症状改善的影响。方法:回顾性队列研究在沙特阿拉伯利雅得法赫德国王医疗城姑息治疗部门进行。该研究包括所有接受住院姑息治疗并在2022年1月至2023年3月期间死亡的晚期癌症患者。分析医疗记录数据以评估感染相关症状、抗生素使用和诊断后3天(D3)症状改善情况。结果:共纳入220例患者,平均年龄61±17岁,平均姑息治疗表现评分为37%。89%的患者使用抗生素,主要是经验性的(82%)。哌拉西林/他唑巴坦(53%)和美罗培南(17%)是最常用的抗生素。有症状的患者中有54% (n = 95)在D3治疗后症状改善。发热(42% - 15%,P P = 0.004)和呼吸急促(32% - 20%,P = 0.003)的改善显著。logistic回归模型分析未发现显著的症状改善预测因子。结论:抗生素在晚期肿瘤患者EoL护理中广泛应用,但对症状改善的影响不大。研究结果强调需要在个性化护理目标和跨学科合作的指导下明智地使用抗生素,以优化症状管理,同时最大限度地减少不必要的干预。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Palliative Care
Journal of Palliative Care 医学-卫生保健
CiteScore
3.20
自引率
5.90%
发文量
63
审稿时长
>12 weeks
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.
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