Mamak Tahmasebi, Hadiseh Hosamirudsari, Shirin Familrashtian, Masoud Parash, Mohammadreza Salehi, Mahsa Abbaszadeh
Cancer Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Infectious Diseases, Baharloo Hospital, Railway Square, Tehran University of Medical Sciences, Tehran, Iran.
Cancer Inform. 2023 Mar 29;22:11769351231161476. doi: 10.1177/11769351231161476. eCollection 2023.
In this study our aim was to elucidate whether advanced cancer patients benefit from antibiotic treatment in the last days of life in addition to reviewing the relevant costs and effects.
We reviewed medical records from 100 end-stage cancer patients and their antibiotic use during the hospitalization in Imam Khomeini hospital. Patient's medical records were analyzed retrospectively for cause and periodicity of infections, fever, increase in acute phase proteins, cultures, type and cost of antibiotic.
Microorganisms were found in only 29 patients (29%) and the most microorganism among the patients was E. coli (6%). About 78% of the patients had clinical symptoms. The highest dose of antibiotics was related to Ceftriaxone (40.2%) and in the second place was Metronidazole (34.7%) and the lowest dose was related to Levofloxacin, Gentamycin and Colistin (1.4%). Fifty-one patients (71%) did not have any side effects due to antibiotics. The most common side effect of antibiotics among patients was skin rash (12.5%). The average estimated cost for antibiotic use was 7 935 540 Rials (24.4 dollars).
Prescription of antibiotics was not effective in symptom control in advanced cancer patients. The cost of using antibiotics during hospitalization is very high and also the risk of developing resistant pathogens during admission should be considered. Antibiotic side effects also occur in patients, causing more harm to the patient at the end of life. Therefore, the benefits of antibiotic advice in this time is less than its negative effects.
在本研究中，我们的目的是阐明晚期癌症患者在生命的最后几天接受抗生素治疗是否有益，同时回顾相关成本和效果。
我们回顾了伊玛目霍梅尼医院100例晚期癌症患者的病历及其住院期间的抗生素使用情况。对患者的病历进行回顾性分析，以了解感染的原因和周期性、发热、急性期蛋白增加、培养结果、抗生素类型和成本。
仅在29例患者（29%）中发现微生物，患者中最常见的微生物是大肠杆菌（6%）。约78%的患者有临床症状。抗生素使用剂量最高的是头孢曲松（40.2%），其次是甲硝唑（34.7%），剂量最低的是左氧氟沙星、庆大霉素和黏菌素（1.4%）。51例患者（71%）未出现抗生素相关的任何副作用。患者中抗生素最常见的副作用是皮疹（12.5%）。抗生素使用的平均估计成本为7935540里亚尔（24.4美元）。
抗生素处方对晚期癌症患者的症状控制无效。住院期间使用抗生素的成本非常高，同时还应考虑住院期间产生耐药病原体的风险。患者也会出现抗生素副作用，在生命末期对患者造成更大伤害。因此，此时使用抗生素的益处小于其负面影响。
