Assessment of the need for a home intravenous antibiotic program

Home intravenous antibiotic programs (HIAP) have been in existence for more than 12 years. The feasibility of such a program at the UBC-HSCH was assessed. The health records of all patients discharged between April 1, 1985 to March 31, 1987 with a diagnosis of septic arthritis, osteomyelitis, pyelonephritis, skin and soft tissue infections in the diabetic, prostatitis or infective endocarditis were reviewed retrospectively. Selection criteria to determine eligibility of patients for a HIAP were derived from the literature and grouped into three areas: patient, disease, and treatment criteria. From a total of 184 patients identified, 14 diabetic patients were excluded. The exclusion of patients with hospital stays of less than five days or those that did not have the appropriate diagnosis resulted in 77 patients available for more extensive review. Sixteen of 77 patients (20.8%) were judged eligible for a HIAP: 1 of 22 with pyelonephritis; 4 of 12 with septic arthritis; 5 of 21 with prostatitis; 2 of 12 with infective endocarditis; 4 of 10 with osteomyelitis. A total of 81 hospital bed days ($20,250.00) might have been saved if a HIAP was in place.