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

JAMA. 1990 Jun 20;263(23):3168-72.


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.

KIE: The object of this study was to compare the effectiveness of antibiotic treatment for fever with a palliative approach in a group of hospitalized patients with Alzheimer's disease. One hundred and four patients were divided into three groups, based on the occurrence of fever and on the treatment strategy used, and observed for 34 months. Those who developed fevers had more advanced disease than those who did not. The incidence of fever was similar for the antibiotic and palliative groups, and for the more severely demented patients in each group there was no difference in survival. Among less demented patients those who received antibiotics had a higher rate of survival than those who received palliative treatment. The authors suggest that these observations should be taken into account by health personnel and family members weighing the benefits and burdens of diagnostic workups and treatments in Alzheimer's patients with fevers.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • 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*


  • Anti-Bacterial Agents