Antibiotics generally are successful in combating most types of infections, with patients showing improvement within a few hours or days, and complete cure within a few days or weeks. With older persons, the outcome of antibiotic treatment for life-threatening infections are often unpredictable. However, antibiotic therapy is especially important for chronically ill older people receiving long-term mechanical ventilation, dialysis, or nutritional support. Without antibiotic treatment of the iatrogenic infections often associated with these technologies, it would be impossible to restore these patients to a clinically stable condition. Antibiotics enable these other technologies to sustain lives.
Antibiotics are the least complex and least expensive life-sustaining technologies.
Because physicians consider antibiotics ordinary or standard treatment, their decisions to use them in the treatment of life-threatening infections are often automatic. Clinic criteria, rather than patient's or surrogate's wishes, are often their primary considerations. In addition, many elderly patients being considered for life-sustaining antibiotic treatment are severely debilitated and incapable of making treatment decisions. Decisionmaking aids like the living will are rarely of use to these people, who often have been incapacitated for a long time and are unlikely to have given specific prior directives regarding their care. The outcomes of life-sustaining antibiotic treatment range from complete cure to death.