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Published on: February 9, 2011

Adverse effects of outpatient parenteral antibiotic therapy

M L Hoffman-Terry1, H S Fraimow, T R Fox

  • 1Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

The American Journal of Medicine
|May 13, 1999
PubMed
Abstract

Insights

Home parenteral antimicrobial therapy is common but carries risks similar to inpatient treatment. Close monitoring is essential to prevent adverse events and rehospitalizations from this common therapy.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Patient Safety

Background:

  • Home parenteral antimicrobial therapy is increasingly utilized.
  • Limited research exists on the adverse effects of home infusion antibiotics.

Purpose of the Study:

  • To investigate the adverse effects and complications associated with home parenteral antimicrobial therapy.
  • To identify risk factors and common complications in patients receiving home antibiotic infusions.

Main Methods:

  • Retrospective review of medical records for 269 patients receiving 291 courses of home parenteral antimicrobial therapy.
  • Exclusion of patients with human immunodeficiency virus (HIV) infection.
  • Analysis of adverse events including hematologic, renal, gastrointestinal, dermatologic, and catheter-related complications.

Main Results:

  • Bone and joint infections were the most common indication (59%).
  • Adverse effects included leukopenia (16%), neutropenia (7%), thrombocytopenia (4%), eosinophilia (12%), and nephrotoxicity (8%).
  • Line complications occurred in 9-11% of patients with indwelling catheters, and 8% of patients required rehospitalization.

Conclusions:

  • Home infusion antibiotic therapy presents risks comparable to inpatient administration.
  • Close monitoring is crucial to mitigate serious complications and reduce rehospitalization rates.
  • Beta-lactam antibiotics were frequently associated with hematologic and dermatologic adverse effects.

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