We prospectively evaluated the effect of antibiotic treatment on infection-related symptoms in patientswith advanced cancer, in addition to assessing infection characteristics. Methods: A questionnaire was completed for enrolled patients using a personal digital assistant. Pre-antibiotic and post-antibiotic treatment Edmonton Symptom Assessment Scale (ESAS) scores were evaluated. Patient and the patient's physician identified infection-related symptoms experienced by the patient, which were documented under the "other" category on the ESAS. Pre-antibiotic and post-antibIotic scores of the patient and physician for the identified infection-related symptoms wereevaluated. Results: Twenty-six patients on a tertiary palliative care unit with 31 episodes of infection were included for analysis. Patients' pre-and post-antibiotic ESAS scores revealed a small improvement in allvariables exceptanxiety. Patient assessment of symptoms related to infection showed a small improvement in all symptoms, with dsyuria being statistically significant. Physician assessment revealed a slight improvement for all the symptoms, although only cough was statistically significant. A general comparative physician assessment of patient outcome following antibiotic treatment suggested symptomimprovement in 48.4% of patients. However, 50% of patientsdied within a week of antibiotic discontinuation. Conclusions: Antibiotic treatment appears to offer a mild improvement in infection-related symptoms. Patients reported the greatest improvement in dysuria, and physicians, in cough. Despite this symptomatic improvement, one quarter of the patients died within one week of antibiotic administration. Further comparative studies to evaluate symptomatic benefit, patient burden, and cosVbenefit of antibiotic therapy in the treatment of infections in advanced cancerpatients arerequired.
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