Antibiotic prescription for fever episodes in hospice patients

Liang Kung Chen, Yu Ching Chou, Pi Shan Hsu, Shih Tzu Tsai, Shinn Jang Hwang*, Bin Yuan Wu, Ming Huei Lin, Tzen Wen Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

Bacterial infection usually plays an important part in the fever episodes that are common in patients in the hospice palliative care unit. The physicians' attitude to use of antibiotics in such cases is usually complex. We retrospectively studied 535 admissions to a hospice and palliative care unit in a medical center in Taiwan. Ninety-three fever episodes (16.7%) were identified among these admissions, and 79 fever episodes (84.9%) were treated with antibiotics. The Karnofsky performance status (KPS), verbal communication ability (VCA) and Glasgow Coma Scale (GCS) were all significantly compromised in these febrile patients. Although KPS, VCA and GCS were similar among all patients at the date of admission, these parameters became significantly worse in fever episodes that were left untreated than in those treated with antibiotics. Patients without antibiotic treatment showed a shorter mean survival (8.7±9.9 days vs 14.6±13.1 days; P=0.03) and a higher 3-day mortality rate than those patients with antibiotic treatment (50% vs 15.2%; P=0.015). In conclusion, appropriate antibiotic use may cause fever to subside and thus decrease the fever-related discomfort. Physicians may tend to withhold antibiotic treatment because of the poorer KPS, VCA, and GCS and poorer estimated prognosis of patients at the time of fever.

Original languageEnglish
Pages (from-to)538-541
Number of pages4
JournalSupportive Care in Cancer
Volume10
Issue number7
DOIs
StatePublished - 2002

Keywords

  • Antibiotics
  • Cancer
  • Fever
  • Hospices
  • Palliative care

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