<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1665-1146</journal-id>
<journal-title><![CDATA[Boletín médico del Hospital Infantil de México]]></journal-title>
<abbrev-journal-title><![CDATA[Bol. Med. Hosp. Infant. Mex.]]></abbrev-journal-title>
<issn>1665-1146</issn>
<publisher>
<publisher-name><![CDATA[Instituto Nacional de Salud, Hospital Infantil de México Federico Gómez]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1665-11462023000500279</article-id>
<article-id pub-id-type="doi">10.24875/bmhim.23000039</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Antibiotics in the end-of-life phase in pediatric oncological patients with a diagnosis of terminal illness: a dilemma]]></article-title>
<article-title xml:lang="es"><![CDATA[Uso de antibióticos en niños con patología oncológica en la fase final de vida: el dilema]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Paez-Velasquez]]></surname>
<given-names><![CDATA[Jackelyn S.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Márquez-González]]></surname>
<given-names><![CDATA[Horacio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guadarrama-Orozco]]></surname>
<given-names><![CDATA[Jéssica H.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Infantil de México Federico Gómez Alergología e Inmunología Pediátrica ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Infantil de México Federico Gómez Departamento de Apoyo a la Investigación ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Infantil de México Federico Gómez Departamento de Cuidados Paliativos y Calidad de Vida ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>10</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>10</month>
<year>2023</year>
</pub-date>
<volume>80</volume>
<numero>5</numero>
<fpage>279</fpage>
<lpage>287</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1665-11462023000500279&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1665-11462023000500279&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1665-11462023000500279&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background: Pediatric cancer patients in the final phase of life receive antibiotics empirically. The decision to start, maintain, or stop the antibiotic administration as part of care at this stage is a dilemma.  Methods: We conducted a retrospective, descriptive, cross-sectional study including cancer patients in the final phase of life, hospitalized during the last 5 to 7 days of life. We included demographic variables, diagnoses, days of hospitalization, cultures, antibiotics used, prevalent symptoms in the last week of life, and principal diagnosis at the time of death, and performed descriptive statistics and a chord diagram.  Results: Twenty-two patients were included; 18 (81.81%) received antibiotic treatment. The mean age was 8.75 years. The predominant pathologies were central nervous system tumors in seven patients (31.81%). Of the total, 18 (81.81%) had an infectious diagnosis reported as bloodstream infection, followed by pneumonia in three (13.63%). The main cause of death was respiratory failure (40.9%). Of the 18 patients with an infectious diagnosis, 16 (88.88%) received empiric therapy. Predominant factors for antibiotic use were more than 7 days of hospitalization (75%), ICU admission (100%), invasive devices (88.8%), and aminergic support (100%). The predominant symptoms were dyspnea (68.18%), pain (50%), and fever (40.9%), which persisted in nine (60%), two (18.18%), and five (55.5%) patients, respectively.  Conclusions: The lack of guidelines for antibiotic administration leads to excessive and potentially unnecessary use, which can lead to discomfort, prolonged hospitalization, bacterial resistance, excessive cost, and suffering without symptom control.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: Los pacientes pediátricos oncológicos en la fase final de vida reciben antibióticos de forma empírica. La decisión de iniciar, mantener o suspender la administración del antibiótico como parte del cuidado en esta etapa es un dilema.  Métodos: Se llevó a cabo un estudio retrospectivo, descriptivo y transversal que incluyó pacientes oncológicos en fase final de vida, hospitalizados durante los últimos 5 a 7 días de vida. Se incluyeron variables demográficas, diagnósticos, días de estancia hospitalaria, cultivos, antibióticos utilizados, síntomas prevalentes en la última semana de vida y diagnóstico principal al momento de fallecer. Se realizó estadística descriptiva y un gráfico de cuerdas.  Resultados: Se incluyeron 22 pacientes: 18 (81.81%) recibieron manejo antibiótico. La media de edad fue de 8.75 años. Las patologías predominantes fueron tumores de sistema nervioso central en siete pacientes (31.81%). Del total, 18 (81.81%) pacientes presentaron infección del torrente sanguíneo; tres (13.63%) presentaron neumonía. La principal causa de muerte fue insuficiencia respiratoria (40.9%). De los 18 pacientes con diagnóstico infeccioso, 16 (88.88%) recibieron terapia empírica. Los factores prevalentes para el uso antibiótico fueron una estancia hospitalaria mayor a 7 días (75%), hospitalización en Unidad de Cuidados Intensivos (100%), dispositivos invasivos (88.8%) y apoyo aminérgico (100%). El síntoma prevalente fue disnea (68.18%), dolor (50%) y fiebre (40.9%), mismos que persistieron en nueve (60%), dos (18.18%) y cinco pacientes (55.5%), respectivamente.  Conclusiones: La falta de pautas respecto a la administración de antibióticos conlleva a su uso excesivo y potencialmente innecesario, lo cual puede ocasionar incomodidad, prolongar la hospitalización, resistencia bacteriana, costos excesivos y sufrimiento, sin control de los síntomas.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Antibiotics]]></kwd>
<kwd lng="en"><![CDATA[Terminal illness]]></kwd>
<kwd lng="en"><![CDATA[Pediatric oncology]]></kwd>
<kwd lng="es"><![CDATA[Antibióticos]]></kwd>
<kwd lng="es"><![CDATA[Enfermedad terminal]]></kwd>
<kwd lng="es"><![CDATA[Oncología pediátrica]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<source><![CDATA[WHO Definition of palliative care]]></source>
<year>2002</year>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[World Health Organization]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sosa-Sánchez]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Ramírez-Mora]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Alarcón-Almanza]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Fuentes-García]]></surname>
<given-names><![CDATA[VE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cuidados paliativos en el Hospital Infantil de México Federico Gómez:una realidad]]></article-title>
<source><![CDATA[Rev Mex Anest]]></source>
<year>2014</year>
<volume>37</volume>
<page-range>171-6</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<collab>American Academy of Pediatrics</collab>
<collab>Committee on Bioethics and Committee on Hospital Care</collab>
<article-title xml:lang=""><![CDATA[Palliative care for children]]></article-title>
<source><![CDATA[Pediatrics]]></source>
<year>2000</year>
<volume>106</volume>
<page-range>351-7</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[van Nordennen]]></surname>
<given-names><![CDATA[RT]]></given-names>
</name>
<name>
<surname><![CDATA[Lavrijsen]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Vissers]]></surname>
<given-names><![CDATA[KC]]></given-names>
</name>
<name>
<surname><![CDATA[Koopmans]]></surname>
<given-names><![CDATA[RT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Decision making about change of medication for comorbid disease at the end of life:an integrative review]]></article-title>
<source><![CDATA[Drugs Aging]]></source>
<year>2014</year>
<volume>31</volume>
<page-range>501-12</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Thompson]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Silveira]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Vitale]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
<name>
<surname><![CDATA[Malani]]></surname>
<given-names><![CDATA[PN]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Antimicrobial use at the end of life among hospitalized patients with advanced cancer]]></article-title>
<source><![CDATA[Am J Hosp Palliat Care]]></source>
<year>2012</year>
<volume>29</volume>
<page-range>599-603</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Juthani-Mehta]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Malani]]></surname>
<given-names><![CDATA[PN]]></given-names>
</name>
<name>
<surname><![CDATA[Mitchell]]></surname>
<given-names><![CDATA[SL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Antimicrobials at the end of life:an opportunity to improve palliative care and infection management]]></article-title>
<source><![CDATA[JAMA]]></source>
<year>2015</year>
<volume>314</volume>
<page-range>2017-8</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Albrecht]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[McGregor]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Fromme]]></surname>
<given-names><![CDATA[EK]]></given-names>
</name>
<name>
<surname><![CDATA[Bearden]]></surname>
<given-names><![CDATA[DT]]></given-names>
</name>
<name>
<surname><![CDATA[Furuno]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A nationwide analysis of antibiotic use in hospice care in the final week of life]]></article-title>
<source><![CDATA[J Pain Symptom Manage]]></source>
<year>2013</year>
<volume>46</volume>
<page-range>483-90</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rosenberg]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Albrecht]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Fromme]]></surname>
<given-names><![CDATA[EK]]></given-names>
</name>
<name>
<surname><![CDATA[Noble]]></surname>
<given-names><![CDATA[BN]]></given-names>
</name>
<name>
<surname><![CDATA[McGregor]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Comer]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Antimicrobial use for symptom management in patients receiving hospice and palliative care:a systematic review]]></article-title>
<source><![CDATA[J Palliat Med]]></source>
<year>2013</year>
<volume>16</volume>
<page-range>1568-74</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="book">
<source><![CDATA[Ley General de Salud]]></source>
<year>2016</year>
<publisher-loc><![CDATA[Mexico City ]]></publisher-loc>
<publisher-name><![CDATA[Secretaría de Salud]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Oh]]></surname>
<given-names><![CDATA[DY]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[DW]]></given-names>
</name>
<name>
<surname><![CDATA[Im]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[TY]]></given-names>
</name>
<name>
<surname><![CDATA[Heo]]></surname>
<given-names><![CDATA[DS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Antibiotic use during the last days of life in cancer patients]]></article-title>
<source><![CDATA[Eur J Cancer Care (Engl)]]></source>
<year>2006</year>
<volume>15</volume>
<page-range>74-9</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stiel]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Krumm]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Pestinger]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Lindena]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Nauck]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Ostgathe]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Antibiotics in palliative medicine:results from a prospective epidemiological investigation from the HOPE survey]]></article-title>
<source><![CDATA[Support Care Cancer]]></source>
<year>2012</year>
<volume>20</volume>
<page-range>325-33</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Enck]]></surname>
<given-names><![CDATA[RE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Antibiotic use in end-of-life care:a soft line?]]></article-title>
<source><![CDATA[Am J Hosp Palliat Care]]></source>
<year>2010</year>
<volume>27</volume>
<page-range>237-8</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Medina]]></surname>
<given-names><![CDATA[ZLE]]></given-names>
</name>
<name>
<surname><![CDATA[Cruz]]></surname>
<given-names><![CDATA[CAM]]></given-names>
</name>
<name>
<surname><![CDATA[Sánchez]]></surname>
<given-names><![CDATA[SME]]></given-names>
</name>
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[PAA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Nivel de conocimientos del personal de salud sobre cuidados paliativos]]></article-title>
<source><![CDATA[Rev Esp Med Quir]]></source>
<year>2012</year>
<volume>17</volume>
<page-range>109-14</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[D'Agata]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Mitchell]]></surname>
<given-names><![CDATA[SL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Patterns of antimicrobial use among nursing home residents with advanced dementia]]></article-title>
<source><![CDATA[Arch Intern Med]]></source>
<year>2008</year>
<volume>168</volume>
<page-range>357-62</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mirhosseini]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Oneschuk]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Hunter]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Hanson]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Quan]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Amigo]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The role of antibiotics in the management of infection related symptoms in advanced cancer patients]]></article-title>
<source><![CDATA[J Palliat Care]]></source>
<year>2006</year>
<volume>22</volume>
<page-range>69-74</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Homsi]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Walsh]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Panta]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Lagman]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Nelson]]></surname>
<given-names><![CDATA[KA]]></given-names>
</name>
<name>
<surname><![CDATA[Longworth]]></surname>
<given-names><![CDATA[DL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Infectious complications of advanced cancer]]></article-title>
<source><![CDATA[Support Care Cancer]]></source>
<year>2000</year>
<volume>8</volume>
<page-range>487-92</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chun]]></surname>
<given-names><![CDATA[ED]]></given-names>
</name>
<name>
<surname><![CDATA[Rodgers]]></surname>
<given-names><![CDATA[PE]]></given-names>
</name>
<name>
<surname><![CDATA[Vitale]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
<name>
<surname><![CDATA[Collins]]></surname>
<given-names><![CDATA[CD]]></given-names>
</name>
<name>
<surname><![CDATA[Malani]]></surname>
<given-names><![CDATA[PN]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Antimicrobial use among patients receiving palliative care consultation]]></article-title>
<source><![CDATA[Am J Hosp Palliat Care]]></source>
<year>2010</year>
<volume>27</volume>
<page-range>261-5</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gracia]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tomar decisiones morales:Del casuismo a la deliberación]]></article-title>
<source><![CDATA[Dilemata]]></source>
<year>2016</year>
<volume>20</volume>
<page-range>15-31</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[DeCourcey]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Silverman]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Oladunjoye]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Wolfe]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Advance care planning and parent-reported end-of-life outcomes in children, adolescents, and young adults with complex chronic conditions]]></article-title>
<source><![CDATA[Crit Care Med]]></source>
<year>2019</year>
<volume>47</volume>
<page-range>101-8</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lord]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Moore]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Beatty]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Cohen]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Rappaport]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Hellmann]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Assessment of bereaved caregiver experiences of advance care planning for children with medical complexity]]></article-title>
<source><![CDATA[JAMA Netw Open]]></source>
<year>2020</year>
<volume>3</volume>
</nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bernadá]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Notejane]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Planificación avanzada del cuidado y adecuación del esfuerzo terapéutico en Pediatría. Fundamento y procedimiento]]></article-title>
<source><![CDATA[Arch Pediatr Urug]]></source>
<year>2022</year>
<volume>93</volume>
</nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Reinbolt]]></surname>
<given-names><![CDATA[RE]]></given-names>
</name>
<name>
<surname><![CDATA[Shenk]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[White]]></surname>
<given-names><![CDATA[PH]]></given-names>
</name>
<name>
<surname><![CDATA[Navari]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Symptomatic treatment of infections in patients with advanced cancer receiving hospice care]]></article-title>
<source><![CDATA[J Pain Symptom Manage]]></source>
<year>2005</year>
<volume>30</volume>
<page-range>175-82</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[SF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Antibiotics in palliative care:less can be more. Recognising overuse is easy. The real challenge is judicious prescribing]]></article-title>
<source><![CDATA[BMJ Support Palliat Care]]></source>
<year>2018</year>
<volume>8</volume>
<page-range>187-8</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
