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Intravenous antibiotic therapy at home
Abstract:
During a 12-month period, 23 patients aged 12 to 78 years were treated for 8 to 40 days (mean, 23 days) at home with intravenous (i.v.) antibiotics. Diseases treated included bone and joint infection (14 patients), blastomycosis (two), actinomycosis (two), staphylococcal bacteremia (two), endocarditis (two), and candidal pyelonephritis (one). After initial in-hospital training, patients self-administered their drugs through a heparin-lock i.v. cannula, which was changed regularly by a visiting home care nurse. Antibiotics administered included cloxacillin, penicillin G, cephalosporins, gentamicin, carbenicillin, and amphotericin B. Patient and family acceptance of the program was good, the program was therapeutically effective, and, apart from a decreased prevalence of phlebitis with the heparin lock at home, side effects were no different from those of in-hospital-treated patients. The cost of home therapy was $ 40 per patient-day compared with an estimated $ 137 had the patients remained in hospital. Most patients were able to resume normal activities while receiving home i.v. therapy.
Insights
Home intravenous (IV) antibiotic therapy is safe, effective, and significantly more cost-effective than inpatient care for various infections. Patients and families accepted this treatment model, allowing a return to normal activities.
Area of Science:
- Infectious Diseases
- Pharmacology
- Health Services Research
Background:
- Intravenous (IV) antibiotic therapy is crucial for treating severe infections.
- In-hospital treatment can be costly and limit patient mobility.
- Home-based IV antibiotic programs offer a potential alternative.
Purpose of the Study:
- To evaluate the safety, efficacy, and cost-effectiveness of home-based IV antibiotic therapy.
- To assess patient and family acceptance of home IV antibiotic treatment.
- To compare home therapy outcomes with traditional inpatient care.
Main Methods:
- A 12-month study involving 23 patients (aged 12-78) receiving home IV antibiotics for 8-40 days.
- Treatment included bone and joint infections, blastomycosis, actinomycosis, bacteremia, endocarditis, and candidal pyelonephritis.
- Patients self-administered antibiotics via a heparin-lock IV cannula, with nurse support.
Main Results:
- Therapeutic effectiveness was good across various infections.
- Patient and family acceptance was high.
- Home therapy cost $40/patient-day versus an estimated $137 for inpatient care.
- Side effect profile was similar to inpatient treatment, with reduced phlebitis.
Conclusions:
- Home-based IV antibiotic therapy is a safe, effective, and cost-saving alternative to hospitalization.
- The program facilitates patient recovery and return to normal activities.
- This model demonstrates successful patient self-administration and positive outcomes for complex infections.
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