Home intravenous antibiotic therapy. A safe and effective alternative to inpatient care.
OBJECTIVE
To assess the practicality, safety, cost effectiveness and outcome of receiving intravenous antibiotics at home.


METHODS
Patients with serious bacterial infections requiring parenteral antibiotic therapy were enrolled in a pilot program to receive treatment at home. Antibiotics were premixed in the hospital pharmacy and administered by the Royal District Nursing Service, and medical back-up was provided.


RESULTS
Twenty patients (mean age, 58 years; range, 19-84 years) received 21 courses of intravenous antibiotics at home (mean duration +/- SD, 26 +/- 9 days; range, 11-44 days). Conditions treated included osteomyelitis (10 patients), endocarditis (5), vascular graft and pacemaker sepsis (4), and chronic cellulitis (1). Treatment at home was well tolerated with no significant complications, and cure was achieved in 18 of the 20 patients. It was both efficient and cost effective, with a mean benefit in treatment costs between home and the equivalent inpatient therapy of at least $112 per day for the 538 days that home therapy was provided. Moreover, the reduced bed use could allow an additional hospital throughput of between 86 and 107 patients annually.


CONCLUSIONS
Home intravenous antibiotic therapy is safe, effective and well tolerated. It allows more efficient inpatient care and reduces total treatment costs in an important subpopulation of patients.
Grayson
M L
ML
Infectious Diseases and Microbiology Department, Monash Medical Centre, Melbourne, Vic.
Silvers
J
J
Turnidge
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D003362:Cost-Benefit Analysis; D018575:Home Care Services, Hospital-Based / Q000191:economics; D018718:Home Infusion Therapy / Q000191:economics; D006801:Humans; D007262:Infusions, Intravenous; D007902:Length of Stay; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D014739:Victoria
D000900:Anti-Bacterial Agents