Medical Oncology Department, Portuguese Oncology Institute of Coimbra, Coimbra, Portugal.
Curr Opin Oncol. 2019 Jul;31(4):299-301. doi: 10.1097/CCO.0000000000000514.
The review englobes the latest studies published regarding the problem of antimicrobial usage with palliative intent.
In the advanced stages of illness like cancer, dementia, or neurodegenerative diseases, important decisions have to be made concerning the global treatment plan. Infections are very common among this kind of patients as they typically have multiple comorbidities and are incapacitated. These infections, in a majority of the cases, will be treated with antimicrobial therapy because this is a standard medical procedure. For a health professional, the decision of whether to treat, withhold, or withdraw a treatment can be difficult. In fact, in palliative care, the challenge is to balance compassionate care for people suffering from end-of-life diseases with the need for responsible antibiotic usage. Antimicrobial treatment could alleviate symptoms from an infection and make patients more comfortable, on the other hand, its overuse of it could bring a broader public health risk.
On the contrary, in 18 months there are few studies about this problem, what reveals no concern about the use of antimicrobians in end-of-life patients.
本篇综述囊括了有关姑息治疗中抗菌药物使用问题的最新研究。
在癌症、痴呆或神经退行性疾病等晚期疾病中，必须针对整体治疗计划做出重要决策。此类患者通常患有多种合并症且身体虚弱，因此很容易发生感染。在大多数情况下，这些感染将采用抗菌药物治疗，因为这是标准的医疗程序。对于医疗保健专业人员来说，是否进行治疗、延迟治疗还是停止治疗的决定可能很困难。实际上，在姑息治疗中，挑战在于平衡对患有终末期疾病的人的同情护理与负责任地使用抗生素的需求。抗菌药物治疗可以缓解感染引起的症状，使患者更加舒适，但过度使用也会带来更广泛的公共卫生风险。
相反，在 18 个月内，关于这个问题的研究很少，这表明人们对终末期患者使用抗菌药物的问题并不关注。
