End-of-life use of antibiotics: a survey on how doctors decide

Abstract

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Antibiotics use patterns in end-of-life cancer patients and medical staff’s perception of antimicrobial stewardship programs

“…There have been studies on medical staff’s perceptions of antibiotic stewardship in EOL patients. One survey study found that many doctors who provide palliative care tend to initiate and maintain or extend antibiotics use in EOL patients, even in cases where antibiotics might not be appropriate or where the risks might outweigh the benefits [ 4 ]. Another study found that physicians have divergent attitudes toward the management of infectious diseases in terminally ill patients with cancer [ 29 ].…”

Comment on “Treatment of Positive Urine Cultures at End-of-Life and the Effect on Terminal Delirium Management”

“…Finally, in physician’s perspective, decide not to initiate antibiotics is tough when clinicians suspect infection in end-of-life clinical conditions. 4 Not initiate antibiotics become challenging in some infections, such as urinary tract infections, that may be more likely to improve symptomatically with antimicrobial therapy compared to other infections. 5 Studies that suggest this tendence did not use the same method to evaluate symptomatic improve.…”

Práticas Assistenciais De Equipes Médicas E De Enfermagem Às Pessoas Em Cuidados Paliativos Hospitalizadas

“…A suspensão de antibióticos é uma das decisões que mais gera dúvidas na prática em CP. Um estudo 27 constatou que médicos atuantes em CP, apesar da formação na área, tendem a insistir em antibioticoterapia mesmo diante dos dias ou das horas finais, inclusive realizando substituição de medicamentos em caso de ausência de resposta. Em situações específicas, como diante de 11/15 pacientes oncológicos com baixa funcionalidade e com risco de evolução ao óbito, há maior cuidado e chances de suspensão da terapêutica em questão.…”