Infection at The End Of Life: Is Antimicrobial Therapy of Benefit?
DOI:
https://doi.org/10.24950/rspmi/P.Vista/126/19/4/2019Keywords:
Anti-Bacterial Agents, Bacterial Infections/drug therapy, Deprescriptions, Terminal Care, Terminally IlAbstract
Palliative care includes comprehensive strategies to optimize the quality of life for patients and families confronting
terminal illness. Clinical manifestations and symptoms may
be difficult to interpret. Although inflammation may prevail,
the state of immunosenescence makes the infectious disease pauci-symptomatic and different from usual. Adynamia,
fever, and cough, are often interpreted and medicated as infection. Besides, although infection is common at the end of
life, it is often a marker of gravity and not the problem itself.
Antibiotics, usually used in this context, may not serve the
best interests of the patient and contribute to the development of resistant microorganisms, which has negative implications at the community level. In this article, we discuss
the potential benefits and risks of antibiotic therapy in this
population, which, in our opinion, should be included in the
scope of palliative care.
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