Study Questions Antibiotics Use for Advanced Dementia Patients
Nearly half of advanced-dementia residents in nursing faculties receive antibiotics during the last two weeks of life, but it remains unclear whether such treatment helps, according to a new study from Harvard-affiliated researchers reporting in the Archives of Internal Medicine. Pain from administering the drugs intravenously, as well as unwanted side effects, are among the chief concerns. Extensive use of antimicrobials and pattern of antimicrobial management in advanced dementia raises concerns not only with respect to individual treatment burden near the end of life but also with respect to the development and spread of antimicrobial resistance in the nursing facility setting, according to the report, which recommends development of programs and guidelines designed to reduce the use of antimicrobial agents in advanced dementia. The study followed 200 Boston nursing facility residents with dementia for about 18 months. Nearly three-fourths of the five million Americans with dementia will require nursing facility care. Commonly complicating their stays are repeated infections and fevers, experts said, adding that more research is needed to learn whether physicians ultimately should consider not recommending antibiotics. Alternatives such as oxygen or Tylenol could be better courses of treatment, according to one expert.