title: Antimicrobial Use in Patients with Dementia: Current Concerns and Future Recommendations.
abstract: Infections are common in people with dementia, and antibiotic use is widespread, albeit highly variable, across healthcare settings and countries. The few studies conducted to date that consider the appropriateness of antibiotic prescribing specifically for people with dementia focus on people with advanced dementia and suggest that much of the prescribing of antibiotics for these patients may be potentially inappropriate. We suggest that clinicians must consider a number of factors to determine appropriateness of antimicrobial prescribing for people with dementia, including the risks and benefits of assessing and treating infections, the uncertainty regarding the effects of antibiotics on patient comfort, goals of care and treatment preferences, hydration status, dementia severity and patient prognosis. Future research should examine antibiotic prescribing and its appropriateness across the spectrum of common infections, dementia severities, care settings and countries, and should consider how antibiotic therapy should be considered in discussions regarding treatment preferences, goals of care and/or advance care planning between clinicians, patients and families.
authors.affiliation: School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, BT9 7BL, Belfast, UK. c.parsons@qub.ac.uk.
authors.forename: Carole
authors.initials: C
authors.lastname: Parsons
authors.affiliation: Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.|Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Jenny T
authors.initials: JT
authors.lastname: van der Steen
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology; D003704:Dementia / Q000150:complications*; D014943:Global Health; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data
chemical_list: D000900:Anti-Bacterial Agents