A Retrospective Review of Antimicrobial Usage and Indications at End-of-Life for Oncology Patients in a Tertiary Cancer Center in Saudi Arabia.

OBJECTIVES

To investigate antimicrobial usage patterns, indications, and outcomes in end-of-life (EOL) oncology patients at Princess Noorah Oncology Center (PNOC), King Abdulaziz Medical City, Jeddah, Saudi Arabia. The use of antimicrobials in oncology patients in EOL care has raised concerns about their appropriateness and the increasing issue of antimicrobial resistance.

METHODS

The study is a retrospective chart review of cancer patients treated at the PNOC from January 1, 2017, to January 31, 2022. The inclusion criteria included cancer patients ≥18 years who died during their admission. The exclusion criteria included subjects who did not meet the inclusion criteria.

RESULTS

Among the 503 patients analyzed, 89.7% received antimicrobial treatment. In 66.5% of cases, the antimicrobial prescriptions were justified by positive culture results, whereas 33.5% were administered without culture confirmation. The most used antimicrobials were Piperacillin-Tazobactam (20.2%) and Vancomycin (11.4%). Antimicrobial use was significantly associated with patient awareness of their diagnosis (p = 0.036) and metastatic status (p = 0.027). The median duration of antimicrobial administration was 7.0 days.

CONCLUSIONS

The study highlights the prevalent use of antimicrobials for oncology patients in EOL care, with 89.7% taking antimicrobials. The findings emphasize the need for strong antimicrobial stewardship programs to optimize antimicrobial prescription, aiming to decrease antimicrobial resistance.