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Antibiotics in hospice may do more harm than good for most patients. A large retrospective study found that antibiotic use in hospice patients was linked to a 47% higher risk of death — except for those with infection-related conditions, who actually lived longer with treatment. The findings call for more personalized, patient-preference-driven prescribing at the end of life.
A new study published in Clinical Infectious Diseases raises important questions about routine antibiotic use in hospice settings. Researchers at Mayo Clinic analyzed over 6,100 hospice patients and found that, overall, antibiotic use was associated with a significantly higher risk of death — not a longer life. But the story isn't one-size-fits-all.
For most hospice patients — including those with cancer, cardiac, or neurologic conditions — antibiotics appeared to be associated with shorter survival rather than extended life. However, patients whose hospice-qualifying condition was infection-related actually saw a survival benefit from antibiotic treatment, suggesting that targeted use still has a role in end-of-life care.
By the Numbers
Why it matters: These findings challenge the assumption that antibiotics are always beneficial in hospice care. For clinicians, this is a call to move toward individualized, preference-sensitive prescribing — ensuring that end-of-life treatment aligns with what patients actually want and need.
