Caregiver & Elder Care News
Patients Moving from Hospital to
Hospice Often Prescribed Questionable Antibiotics
About 27% of
hospice patients still taking antibiotics for infection in the final
week of their life
2014 - New research suggests that use of antibiotics is still prevalent
among terminal patients who have chosen hospice care as an end-of-life
option, despite little evidence that the medications improve symptoms or
quality of life, and sometimes may cause unwanted side effects.
The use of
antibiotics is so engrained in contemporary medicine that 21 percent of
patients being discharged from hospitals directly to a hospice program
leave with a prescription for antibiotics, even though more than one
fourth of them don’t have a documented infection during their hospital
percent of hospice patients are still taking antibiotics in the final
week of their life.
serious questions about whether such broad and continued antibiotic use
is appropriate in so many hospice cases, experts say, where the
underlying concept is to control pain and protect the remaining quality
of life without aggressively continuing medical treatment.
concerns with antibiotic use, the study concluded, include medication
side effects and adverse events, increased risk of subsequent
opportunistic infections, prolonging the dying process and increasing
the risk of developing antibiotic resistant microorganisms.
were just published in Antimicrobial Agents and Chemotherapy by
researchers from Oregon State University, Corvallis,
Ore. and the Oregon Health
& Science University. It was supported by the National Institutes of
care is very patient centered and in terminal patients it focuses on
palliative care and symptom relief, not curative therapy,” said Jon
Furuno, an associate professor in the Oregon State University/Oregon
Health & Science University College of Pharmacy.
for everyone, and it’s a serious decision people usually make in
consultation with their family, nurses and doctors. These are tough
conversations to have.
decided to use hospice, however, the frequency and prevalence of
antibiotic use in this patient population is a concern,” Furuno said.
“Antibiotics themselves can have serious side effects that sometimes
cause new problems, a factor that often isn’t adequately considered. And
in terminally-ill people they may or may not work anyway.”
as this, Furuno said, continue to crop up in the evolving issue of
hospice care, which is still growing in popularity as many people choose
to naturally allow their life to end with limited medical treatment and
often in their own homes. Hospice is covered by Medicare for people with
a life expectancy of less than six months, helps to control medical
costs and reduce hospital stays, and its services are now used by more
than one third of dying Americans.
and inappropriate antibiotic use is already a concern across all
segments of society, researchers said in the report, and more efforts
are clearly needed to address the issue in hospice patients. The design
of the study probably leads to it underestimating the significance of
the problem, the researchers wrote in their conclusion.
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