Safe intravenous antibiotic therapy at home: experience of a UK based programme.

Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.

Safe intravenous antibiotic therapy at home: experience of a UK based programme.

J Antimicrob Chemother. 1996 May;37(5):1023-9. Unique Identifier : AIDSLINE MED/96346916
Kayley J; Berendt AR; Snelling MJ; Moore H; Hamilton HC; Peto TE; Crook DW; Conlon CP; East Oxford Health Centre, UK.

Abstract: Outpatient i.v. antibiotic therapy is well developed in the United States, largely because of pressures from third-party payers to reduce costs of medical care. We have developed an outpatient i.v. antibiotic programme in Oxford, that has evolved from a desire to provide high quality i.v. therapy to AIDS patients with cytomegalovirus retinitis. We describe the rationale of the service and report on our first two years' experience. We treated 67 consecutive patients (eight with HIV infection) at home with i.v. antibiotics. This resulted in a saving of 2275 hospital days for those patients without HIV infection. HIV positive patients received 69 months of home i.v. therapy. Minor intravascular catheter complications occurred in only five patients (7.5%). The only serious complications were three episodes of catheter-related sepsis (4.5%), all occurring in AIDS patients who had lines in for more than six months. We have shown that home i.v. antibiotic therapy can be delivered safely to patients with a wide variety of infectious problems using the existing network of community nurses in the National Health Service. Essential components to the programme include a multidisciplinary team working between the hospital and community and a written shared care protocol. Such a programme can result in reduced lengths of hospital stay and patient, community nurse and physician satisfaction.

Keywords: Antibiotics/*ADMINISTRATION & DOSAGE/THERAPEUTIC USE Bacterial Infections/*DRUG THERAPY/EPIDEMIOLOGY Ceftriaxone/ADMINISTRATION & DOSAGE/THERAPEUTIC USE Cost-Benefit Analysis Cytomegalovirus Retinitis/COMPLICATIONS/DRUG THERAPY/EPIDEMIOLOGY Ganciclovir/ADMINISTRATION & DOSAGE/THERAPEUTIC USE Gentamicins/ADMINISTRATION & DOSAGE/THERAPEUTIC USE Great Britain Home Care Services/ORGANIZATION & ADMIN Home Infusion Therapy/*ECONOMICS/NURSING/*STATISTICS & NUMER DATA Human HIV Infections/COMPLICATIONS/*DRUG THERAPY/EPIDEMIOLOGY Outcome Assessment (Health Care) Vancomycin/ADMINISTRATION & DOSAGE/THERAPEUTIC USE JOURNAL ARTICLE
970228
M9721875

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