Do Antibiotics Improve Survival, Quality of Life, and Comfort in Patients with Advanced Dementia and Pneumonia?

AbstractPatients 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?"

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Publication Details

Journal
NEJM Evidence
Published
2025-12-23
DOI
https://doi.org/10.1056/evidtt2400447
Primary Topic
Intensive Care Unit Cognitive Disorders
Type
article
Field-Weighted Citation Impact
0.00
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article

Do Antibiotics Improve Survival, Quality of Life, and Comfort in Patients with Advanced Dementia and Pneumonia?

Aisha Ahmad, Jenny T van der Steen
NEJM Evidence
Intensive Care Unit Cognitive Disorders
article

Do Antibiotics Improve Survival, Quality of Life, and Comfort in Patients with Advanced Dementia and Pneumonia?

Aisha Ahmad, Jenny T van der Steen
article en

Abstract

AbstractPatients 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?"

NEJM EvidenceVol. 5(1)
Radboud University Nijmegen (NL), King's College London (GB), Leiden University Medical Center (NL), Radboud University Medical Center (NL), Radboud Institute for Molecular Life Sciences (NL), Sinai Health System (CA), Cicely Saunders International (GB), McMaster University (CA)
Openalex Percentile: Top 33%
Intensive Care Unit Cognitive Disorders
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