Ambulatory antibiotic infusion devices: extending the spectrum of outpatient therapies

To examine the safety and efficacy, as well as the economic impact, of outpatient intravenous antibiotic administration using an ambulatory infusion pump.

Retrospective analysis of patients treated through a single home care pharmacy.

General community and skilled nursing facilities of the greater Monterey (California) area.

Ninety-eight consecutive patients with infections requiring parenteral antibiotics, treated outside the acute-care setting and not eligible for traditional intravenous minibag administration.

Patients received intravenous antibiotics either in the home setting (86%) or in skilled nursing facilities (11%) using a Pharmacia Deltec CADD-VT ambulatory infusion device.

Between April 1, 1986, and July 30, 1988, 98 patients received parenteral antibiotics using an infusion pump, and complete data were available on 96 (98%). A total of 109 treatment courses were given over 1,917 treatment days, with a mean duration of therapy of 18 days. Twenty-three different infections were treated by the use of 12 separate antibiotics. The most common complications included vein irritation (11%) and the inability to maintain venous access (6.2%). Therapy costs were equivalent to or less than the intravenous minibag system depending on the frequency of antibiotic administration. Eighty percent of patients experienced successful resolution of their infection.

Ambulatory antibiotic infusion pumps can be used safely and effectively in the outpatient setting. Use of these pumps should increase the number of patients eligible for out-of-hospital treatment, resulting in a marked reduction in treatment costs.