Antimicrobial therapy in palliative care: an overview

  • Filipa Macedo
  • Catarina Nunes
  • Katia Ladeira
  • Filipa Pinho
  • Nadine Saraiva
  • Nuno Bonito
  • Luísa Pinto
  • Francisco Gonçalves
Review Article


In the advanced stages of illness, patients often face challenging decisions regarding their treatment and overall medical care. Terminal ill patients are commonly affected by infections. However, in palliative care, the use of antimicrobials can be an ethical dilemma. Deciding whether to treat, withhold, or withdraw the antimicrobial treatment for an infection can be difficult. Antimicrobial administration can lead to adverse outcomes but the two main benefits, longer survival and symptom relief, are the main reasons why physicians prescribe antimicrobial when treating terminally ill patients. For the patient who has an irreversible advanced heart or lung disease, or an advanced dementia, or a metastatic cancer, it is easier the decision of withholding mechanical ventilation, tube feeding, and dialysis than antibiotherapy. To characterize infections, agents, and their treatments in palliative care, we conducted a review of the literature. We also included some tips to help health professionals to guide their clinical approach.


Palliative care End of life Antimicrobians Antibiotics Infections Survival 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Filipa Macedo
    • 1
  • Catarina Nunes
    • 2
  • Katia Ladeira
    • 2
  • Filipa Pinho
    • 2
  • Nadine Saraiva
    • 1
  • Nuno Bonito
    • 1
  • Luísa Pinto
    • 2
  • Francisco Gonçalves
    • 2
  1. 1.Portuguese Oncology Institute of CoimbraCoimbraPortugal
  2. 2.Braga HospitalBragaPortugal

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