End of Life Infection Care

A lot of patients in the final stages of life face complicated decisions on their medical care and what should be treated. Infections are one of the most prevalent complications that these patients experience. A lot of clinicians prescribe antimicrobials in the weeks leading up to death. According to the article, 90% of cancer patients are prescribed these medications during the week prior to death. There are risks and benefits associated with prescribing antimicrobials to these patients when they are so close to death. Risks include drug reactions and interactions, the burden of treating more symptoms when the patient is terminally ill, and contributing to drug resistance. However, these medications can contribute to prolonged survival and symptom relief.

I think pharmacists can have a huge impact in these type of situations. Pharmacists, in my opinion, may be the best suited for these decisions and can help physicians make an informed decision. Will this drug be effective enough in relieving symptoms compared to the risks it poses to the patient? Do these medications interact with any treatment the patient is currently on? Pharmacists can weigh the risks and benefits of all of these questions and help other clinicians make informed decisions. This is an excellent article in showing how pharmacists need to be part of the health care team.

JAMA. 2015;314(19):2017-2018