Background: Patients with advanced malignancy have complex symptoms towards end of life. Some of these symptoms include febrile illness and infections. Benefits of treating infection and fever with antibiotics should be weighed out with goals of care for these patients. This study aims to understand the frequency of use of antibiotics and its association with symptom control in the last two weeks of life in advanced cancer patients on best supportive care. Methods: This is an observational retrospective analysis of medical records maintained for advanced cancer patients who have been enrolled in home-based palliative care services. 8 months data was analyzed. Sociodemographic variables, cancer diagnoses, symptoms, use and type of antibiotics prescribed were noted. Relevant statistical analysis was done using IBM SPSS v 25. Results: Of 256 patients included in the analysis, 133 (52%) were male. 57 (22.3% ) patients had gastrointestinal (GI) cancer and 45 ( 17.6%) had lung cancer. 175 (68.4)% died at home and 50 (19.5%) in hospital. 9 (3.1 %) patients had fever. 10 (3.9%) patient had respiratory, and 18 (7%) had gastrointestinal symptoms, respectively. Other symptoms noted were wound infection (10,3.9%), skin and soft tissue (5,2%). Other symptoms noted were wound infection (10,3.9%), skin and soft tissue (5,2%). Only 2 patients had urinary tract symptom. 49 (19.1%) patients had received antibiotics in their last two weeks of life. Intravenous (IV) route of administration was slightly higher than oral (28 vs 21 patients).More than half the patients received 2 antibiotics. Amoxicillin/clavulanate was the most common oral antibiotic and Cefoperazone/ sulbactam was the most common IV antibiotic. Symptom relief was noted in 9 patients (18.4%) however it was statistically significant (p<0.001). Conclusions: Of 256 patients included in the study, 19% had received antibiotics in last two week of their life. Use of intravenous route for antibiotic administration was more than oral route. Gastrointestinal and respiratory symptoms were common cause for antibiotic prescription. Symptomatic benefit was noted with antibiotics use in these patients. Judicious use of antibiotics during end of life care should be considered.