About 21 percent of patients who go directly from hospitals to hospice care for the terminally ill leave the hospital with an antibiotic prescription, even though more than one-quarter didn't have an infection while in the hospital, the researchers found.
Also, 27 percent of hospice patients are still taking antibiotics in their final week of life, according to the study published online recently in the journal Antimicrobial Agents and Chemotherapy.
The extensive use of antibiotics in hospice patients raises concerns because the underlying goal of hospice care is to control pain and protect quality of life without aggressive medical treatment.
Risks of antibiotic use include harmful side effects, a lengthening of the dying process and the development of antibiotic-resistant bacteria.
The "frequency and prevalence of antibiotic use in this patient population is a concern," study author Jon Furuno, an associate professor in the Oregon State University/Oregon Health and Science University College of Pharmacy, said in a university news release.
"Antibiotics themselves can have serious side effects that sometimes cause new problems, a factor that often isn't adequately considered. And in terminally ill people they may or may not work anyway," he said.
In the United States, Medicare covers hospice care for patients expected to live fewer than six months. Unnecessary and improper use of antibiotics in all areas of health care is a major concern.
Due to the design of the study, it likely underestimates the level of antibiotic use among hospice patients, the researchers said.
The U.S. National Library of Medicine has more about hospice care.