Whether or not to start or continue antibiotic therapy in a patient with dementia requires considering the pros and cons.
Patient selection: dementia
The most common infections are pneumonia, urinary tract infection and sepsis.
Factors impacting decision to treat with antibiotics:
(1) severity of dementia
(2) life expectancy and physical status (frailty, malnutrition, etc)
(3) end-of-life documentation
(4) severity of the infection
(5) recurrent infection and predisposing factors (catheterization, tube feeding, etc)
(6) bias for or against patient
(7) distress shown by the patient
(8) resource utilization
Recurrent infections with repeated exposure to antibiotics may be the setting for emergence or resistant strains, especially in nursing homes.
