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Antibiotic use prevalent in hospice patients despite limited evidence of its value
Date:7/14/2014

CORVALLIS, Ore. 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 admission.

About 27 percent of hospice patients are still taking antibiotics in the final week of their life.

This raises 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.

Additional 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.

The findings were just published in Antimicrobial Agents and Chemotherapy by researchers from Oregon State University and the Oregon Health & Science University. It was supported by the National Institutes of Health.

"Hospice 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.

"It's not 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.

"Having decided to use
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Contact: Jon Furuno
furuno@ohsu.edu
503-418-9361
Oregon State University
Source:Eurekalert

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