Fabiszewski K J, Volicer B, Volicer L
Geriatric Research, Education & Clinical Center, E. N. Rogers Memorial Veterans Hospital, Bedford, Mass. 01730.
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.
对104名患有阿尔茨海默病的机构养老患者的发热情况进行了前瞻性评估，以确定抗生素治疗对发热结果的影响。在34个月的观察期内，75名患者出现了172次发热，29名患者未发热。发热患者的病情比未发热患者更为严重。将所有发热都接受诊断检查并接受抗生素治疗的患者（抗生素组）与仅接受舒适护理措施的患者（姑息治疗组）进行比较。抗生素组和姑息治疗组的发热发生率相似。生存分析显示，对于病情较重的患者，两组之间的生存率没有差异。在病情较轻的患者中，抗生素组的生存率高于姑息治疗组。这些结果表明，用抗生素治疗发热并不会改变晚期阿尔茨海默病患者的发热结局。
