have an important place in controlling symptoms in advanced
disease. If an infection is causing symptoms it should be
treated promptly (after a swab or specimen has been taken
for bacteriology) with an appropriate antibiotic (always ask
about drug allergies).
A broad-spectrum antibiotic is indicated for cellulitis, pulmonary or
urinary tract infections, sometimes as a trial in a patient
with sweating that may be secondary to bacteremia, or while
awaiting laboratory sensitivities.
Chloramphenicol 500mg 4 times a day is very useful as a broad-spectrum antibiotic which is active against anaerobes. It is
refreshingly free of side-effects. (Bone marrow damage is
rare, occurring in about 1 in 30,000 patients, which is an
acceptable risk for an individual patient with advanced
occasionally correct practice to withhold antibiotics for a
potentially fatal pneumonia (and treat any symptoms of dyspnea,
cough or pleuritic pains with morphine and scopolamine).
Sometimes during a discussion about quality of life the
patient requests no further active treatment of pulmonary
infections. At other times the decision has to be made by the
doctor (preferably one who knows the patient well) that
further active treatment would be prolonging dying and
“officiously striving to keep alive” rather than promoting
quality of remaining life.
The author and publisher have taken
precautions to ensure that the information in this book is
error-free. However, readers must be guided by their own
personal and professional standards of good practice in
evaluating and applying recommendations made herein. The
contents of this book represent the views and experience of
the author, and not necessarily those of the publisher.