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Antibiotics in hospice care

Nearing the end of life, the use of antibiotics should be carefully considered.

Antibiotics are medical substances used to treat bacterial infections. They have no effect on viruses. In addition to targeting the infection itself, treating bacterial infections with antibiotics can be used to relieve the symptoms of infection.

In the case of a dying patient, the benefits of treatment with antibiotics should be carefully considered. When life expectancy is short, there is rarely time for the antibiotics to treat the infection. In some cases, such as with urinary tract infections, antibiotics may relieve symptoms. On the other hand, antibiotics may have uncomfortable side effects, such as diarrhoea.

Towards the end of life, a fever or elevated inflammatory markers may be caused by something other than a bacterial infection. A fever may be the result of a sizeable tumour or, when death is near, disruptions in the body’s temperature regulation system. These causes cannot be treated with antibiotics. Fever can be brought down effectively with other medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) or paracetamol.

Administering antibiotics intravenously (into a vein) causes discomfort to the patient. If the patient is restless or disoriented, it may also lead to unnecessary restraint measures, such as tying the patient’s hands. This is not a part of good hospice care.

Updated 31.3.2025