Rationalising long-term antimicrobial therapy in palliative care

Follow the principles of medication rationalisation when rationalising antimicrobials in palliative care.

There is little guidance available on when to stop long-term antimicrobial therapy in patients with palliative care needs. Examples of patients who take long-term antimicrobial therapy include patients with human immunodeficiency virus (HIV) infection taking antiretroviral drugs, or patients taking antiviral drugs to prevent reactivation of hepatitis B or hepatitis C when receiving immunosuppressive therapy as part of their cancer treatment. Consult the patient’s specialist for advice.

As patients get closer to death, the potential benefits of antimicrobial treatment diminish relative to the treatment burdenHung, 2022. In the last days of life, antimicrobial therapy, can be stopped without affecting prognosis.

For advice on starting antimicrobial therapy for pneumonia in palliative care, see Pneumonia in palliative care.