To define an optimal
dia-gnostic approach and therapeutic management of
infections in patients with palliative and terminal
cancer care. Along with thromboembolic disease and
cancer progression,
infections are the most frequent causes of death in oncology. Besides the impact on mortality, they are accompanied with a myriad of symptoms decreasing the quality of life. High incidence of infectons is due to a
malignancy itself, the oncolgical
therapy and host factors. There is a lack of evidencebased guidelines and protocols for the
therapy of
infections in palliative and terminal
cancer care. Most of available studies are retrospective in nature, with diverse methods and cohorts. Incidence of
infections in these patient oscillates between 16- 55% in specialized palliative units, and rises up to 83% in acute care hospitals. From the epidemiologic viewpoint, urinary (39- 42%) and
respiratory infections (22- 36%) are the most frequent cases, followed by soft tissue and skin
infections (6- 12%) and
bacteremias (5- 14%). At present, the antibio-
tic treatment does not seem to have a positive impact on the survival rate. Symptom control antibio-
tic therapy as a means of symptom control still remains controversial, since it meets this purpose only in a few percents of studies. The most successful is the symtom control in
urinary tract infections (60- 79%), in contrast to other sites of
infection (30- 43%). In the last week of life there the symptom control is achieved only in 10% of patient. One should always consider the prognosis, actual preformance status and patients preferences when it comes to the management of
dia-gnostics and
therapy of
infections. If the prognosis counts in weeks or months the
dia-gnostics and
therapy should not differ from the approach to any other oncological patient. In terminal
cancer care the antibio-
tics should be spared strictly for the purpose of symptom control and with a palliative intent. This article reviews current knowledge of
dia-gnostics and
therapy of
infections in palliative
cancer care and includes an algorithm for their management.