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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

[Bacterial infections in palliative care: antibiotics and therapeutic limitations]

Nicolas Béziaud1, Patricia Pavese, Didier Barnoud

  • 1Equipe mobile de soins palliatifs et de coordination en soins de support, CHU de Grenoble, F-38043 Grenoble Cedex 09, France. NBeziaud@chu-grenoble.fr

Presse Medicale (Paris, France : 1983)
|January 2, 2009
PubMed

Insights

Antibiotic benefits at end-of-life are limited, mainly for urinary infections. Symptom control, patient wishes, and ethical principles should guide antibiotic prescribing decisions for terminally ill patients.

Area of Science:

  • Medical Ethics
  • Infectious Diseases
  • Palliative Care

Context:

  • Antibiotic use in terminally ill patients presents complex challenges.
  • Prescribing antibiotics at the end of life often offers limited benefits beyond symptomatic urinary tract infections.
  • Widespread antibiotic use contributes to antibiotic resistance and negatively impacts patient quality of life.

Purpose:

  • To evaluate the benefits and drawbacks of antibiotic treatment in end-of-life care.
  • To emphasize symptom control as the primary indication for antibiotic prescription in palliative settings.
  • To outline the ethical considerations and decision-making process for prescribing antibiotics to terminally ill patients.

Summary:

  • Antibiotic treatment benefits are minimal at the end of life, except for symptomatic urinary infections.
  • Prescribing decisions must integrate the patient's overall condition, prognosis, wishes, family input, and symptom management.
  • Physicians must weigh treatment objectives, side effect risks, and patient constraints, adhering to bioethical principles like beneficence, non-maleficence, and patient autonomy.

Impact:

  • Promotes judicious antibiotic stewardship in palliative care.
  • Enhances patient-centered decision-making at the end of life.
  • Reduces the economic and ecological burden of unnecessary antibiotic use and combats antimicrobial resistance.

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