Effect of antibiotic treatment on outcome of fevers in institutionalized Alzheimer patients

• Published in: JAMA : the journal of the American Medical Association Vol. 263; no. 23; p. 3168
• Main Authors: Fabiszewski, K J, Volicer, B, Volicer, L
• Format: Journal Article
• Language: English
• Published: United States 20.06.1990
• Subjects: Age Factors; Aged; Alzheimer Disease - physiopathology; Alzheimer Disease - therapy; Analysis of Variance; Anti-Bacterial Agents - therapeutic use; Clinical Protocols; Female; Fever - drug therapy; Fever - physiopathology; Hospitalization; Humans; Male; Mental Status Schedule; Monitoring, Physiologic; Palliative Care; Patient Selection; Prospective Studies; Risk Assessment; Withholding Treatment; Empirical Approach; Professional Patient Relationship; Mental Health Therapies
• ISSN: 0098-7484
• DOI: 10.1001/jama.1990.03440230064034

Fever episodes in 104 institutionalized patients with Alzheimer's disease were prospectively evaluated to determine the impact of antibiotic treatment on fever outcomes. During the 34-month observation period, 75 patients developed 172 episodes of fever and 29 patients had no fevers. Patients who developed fevers had more advanced disease than patients who did not. Patients who received diagnostic workup of all fevers and treatment with antibiotics (Antibiotic Group) were compared with patients who received comfort measures only (Palliative Group). The incidence of fever was similar in the Antibiotic and Palliative groups. Survival analysis revealed that, for the more severely affected patients, there was no difference in survival between the groups. Among less severely affected patients, survival was higher for the Antibiotic than the Palliative Group. These results suggest that treatment of fever with antibiotics does not alter the outcome of fever in patients with advanced Alzheimer's disease.