Do antibiotics improve survival, quality of life, and comfort in patients with advanced dementia and pneumonia?

Abstract

Patients with advanced dementia and suspected pneumonia are at high risk of death. Antibiotics are commonly prescribed for these patients; however, there is little evidence that treatment meaningfully prolongs life, improves quality of life, or promotes comfort. At the same time, treatment with antibiotics in this population has potential side effects, contributes to antibiotic overuse, and may be burdensome for these frail patients who are near the end of life. This Tomorrow's Trial reviews the existing evidence, and the article proposes a trial to address the question, "Do Antibiotics Improve Survival, Quality of Life, and Comfort in Patients with Advanced Dementia and Pneumonia?"A randomized, double-blind, multicenter trial could help evaluate the efficacy of antibiotics to improve survival, quality of life, and comfort in older adults with advanced dementia and suspected bacterial pneumonia.