Antibiotic Treatment and Survival of Nursing Home Patients With Lower Respiratory Tract Infection: A Cross-National Analysis

Robin L. Kruse; David R. Mehr; Jenny T. van der Steen; Marcel E. Ooms; Richard W. Madsen; Ashley K. Sherman; Ralph B. D’Agostino; Gerrit van der Wal; Miel W. Ribbe

doi:10.1370/afm.389

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Aggressive Care for Demented Nursing Home Residents With Pneumonia May Not Be Effective
James P. Richardson, M.D., M.P.H.

Published on: 06 October 2005
Treating Terminally Ill Patients
Edward T. Bope

Published on: 06 October 2005

Published on: (6 October 2005)
Page navigation anchor for Aggressive Care for Demented Nursing Home Residents With Pneumonia May Not Be Effective
Aggressive Care for Demented Nursing Home Residents With Pneumonia May Not Be Effective
James P. Richardson, M.D., M.P.H., Baltimore, Maryland, USA
This study is a worthy attempt to study the outcomes of various treatments for pneumonia in nursing home residents in two countries with very different approaches. Not surprisingly, the health of the resident prior to onset of pneumonia is more predictive than the specific treatment in frail demented patients. This information may help guide physicians and families facing the difficult decision of whether to hospitalize...
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This study is a worthy attempt to study the outcomes of various treatments for pneumonia in nursing home residents in two countries with very different approaches. Not surprisingly, the health of the resident prior to onset of pneumonia is more predictive than the specific treatment in frail demented patients. This information may help guide physicians and families facing the difficult decision of whether to hospitalize acutely ill nursing home residents.
Competing interests: None declared
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Competing Interests: None declared.
Published on: (6 October 2005)
Page navigation anchor for Treating Terminally Ill Patients
Treating Terminally Ill Patients
Edward T. Bope, Columbus, Ohio
At the core this article raises the social question of how to manage life threatening infection in terminally ill patients. Some will question my use of the term "terminally ill" but these patients were institutionalized and to a large degree demented with no hope for recovery. The Dutch were more likely to withhold antibiotics and less likely to hospitalize or use IM anitibiotics. In my opinion families, guardians an...
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At the core this article raises the social question of how to manage life threatening infection in terminally ill patients. Some will question my use of the term "terminally ill" but these patients were institutionalized and to a large degree demented with no hope for recovery. The Dutch were more likely to withhold antibiotics and less likely to hospitalize or use IM anitibiotics. In my opinion families, guardians and physicians should become uncomfortable with attempting to halt death in bedridden, demented patients. The 90% mortality in the Dutch study of demented patients not receiving antibiotics could be seen as a blessing rather than a fault.
Competing interests: None declared
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Competing Interests: None declared.