RT Journal Article
SR Electronic
T1 Prophylactic antibiotics and corticosteroid prescribing in palliative medicine: retrospective study
JF BMJ Supportive & Palliative Care
JO BMJ Support Palliat Care
FD British Medical Journal Publishing Group
SP spcare-2024-005130
DO 10.1136/spcare-2024-005130
A1 Kruger, Claire
A1 Lannon, Cian
A1 Harnett, Ita
A1 Murtagh, Camilla
YR 2024
UL http://spcare.bmj.com/content/early/2024/10/03/spcare-2024-005130.abstract
AB Objectives To investigate whether patients under the care of the community specialist palliative care team receiving steroids are at increased risk of infection.To identify other risk factors that predispose community palliative care patients to infection.Methods A retrospective chart review of all patients referred to a community specialist palliative care service.Results 177 adult patients were referred to the community specialist palliative care service. Corticosteroids were significantly associated with infection. 39% of patients who received an oral steroid had infection compared with 22% of those who did not receive steroids (OR 2.6 (95% CI 1.07 to 3), RR 1.78 (95% CI 1.08 to 2.9), p=0.02). Regular opioids were significantly associated with infection. 33% of patients receiving a regular opioid had an infection compared with 15% of those not receiving a regular opioid (OR 2.69 (95% CI 1.26 to 5.7), RR 2.06 (95% CI 1.2 to 3.8), p=0.008). Male gender, lung disease, diabetes and immunosuppressive therapies were associated with an increased rate of infection but were not statistically significant.Conclusions Oral corticosteroids were associated with a significantly increased infection rate in a community palliative care population. These patients could potentially benefit from antibiotic prophylaxis while receiving corticosteroids.