Antibiotics overused in dementia patients

A recent study suggests that antibiotics are overused in people dying of dementia and should be prescribed more carefully because of the increasing prevalence of drug-resistant superbugs, according to an article from the Associated Press.

In the study, published in the Feb. 25 issue of the Archives of Internal Medicine, researchers followed more than 200 people with advanced dementia from Boston-area nursing homes for 18 months or until their deaths. Almost half died during that time. All the patients failed to recognize loved ones, had stopped speaking, were unable to walk or feed themselves and were incontinent.

By reviewing medical records, researchers found that 42 percent of these patients received antibiotics—many intravenously—within two weeks of their deaths. The closer they were to death, the more likely they were to receive antibiotics.

Antibiotic overuse contributes to the rise of superbugs, so experts have been recommending physicians become more hesitant to prescribe antibiotics in many types of patients.

Antibiotic overuse in dementia patients also calls to mind the Alzheimer’s Association’s Phase 3 End-of-life care recommendations, which are part of the association’s Dementia Care Practice Recommendations for Assisted Living Residences and Nursing Homes. These recommendations suggest that residents and family members carefully consider the use of antibiotics in care planning for end-stage dementia patients.

We covered this—and other end-of-life issues—extensively in the "Making the Case for Comfort Care" cover story from the May/June 2007 issue of ADVANCE for Long-Term Care Management.