Ethical issues relating to the use of antimicrobial therapy in older adults

E. L. Marcus, A. M. Clarfield, A. E. Moses

Research output: Contribution to journalReview articlepeer-review

50 Scopus citations


This article aims to review the literature relating to the ethics of antibiotic prescription decisions in older adults and to offer some suggestions as to how one might approach these difficult problems. According to many studies, most patients and their family members wish to receive antibiotics even when they are terminally ill or suffering from advanced dementia. Health care professionals are also frequently reluctant to deny the use of antibiotics in such situations. We suggest that the difficult decisions regarding whether one should withhold treatment can be based on consideration of the ethical principles of autonomy, beneficence, nonmaleficence, and justice. From the public health point of view, one should also take into account the need to avoid the emergence of antimicrobial resistance, keeping in mind the balance between the benefit to the specific patient and the cost to future patients. Infectious diseases consultants should actively participate in these ethical dilemmas.

Original languageEnglish
Pages (from-to)1697-1705
Number of pages9
JournalClinical Infectious Diseases
Issue number10
StatePublished - 1 Jan 2001
Externally publishedYes

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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