Home intravenous anti-infective therapy (HIVAT): do the benefits outweigh the risks?

Home intravenous anti-infective therapy (HIVAT) has become an accepted mode of treatment worldwide. There are a number of risks intrinsic to such therapy which can be reduced by a team approach, coupled with careful patient selection criteria, a structured follow-up process and an emphasis on patient education. The benefits of HIVAT include the well-being accrued as a result of being at home, the possibility of returning to work or school, and a reduced risk of infectious and intravenous (IV) cannula-related problems. From a societal standpoint, economic cost-benefit analyses provide ample evidence of cost effectiveness. Studies indicate that potential risks, such as noncompliance, interruption of therapy, drug and IV catheter-associated problems, are infrequent. In the US, reimbursement for HIVAT services for the elderly remains a problem.