title: A prospective cohort study of the use of domiciliary intravenous antibiotics in bronchiectasis.
abstract: BACKGROUND
  We introduced domiciliary intravenous (IV) antibiotic therapy in patients with bronchiectasis to promote patient-centred domiciliary treatment instead of hospital inpatient treatment.
  
  
  OBJECTIVE
  To assess the efficacy and safety of domiciliary IV antibiotic therapy in patients with non-cystic fibrosis bronchiectasis.
  
  
  METHODS
  In this prospective study conducted over 5 years, we assessed patients' eligibility for receiving domiciliary treatment. All patients received 14 days of IV antibiotic therapy and were monitored at baseline/day 7/day 14. We assessed the treatment outcome, morbidity, mortality and 30-day readmission rates.
  
  
  RESULTS
  A total of 116 patients received 196 courses of IV antibiotics. Eighty courses were delivered as inpatient treatment, 32 as early supported discharge (ESD) and 84 as domiciliary therapy. There was significant clinical and quality of life improvement in all groups, with resolution of infection in 76% in the inpatient group, 80% in the ESD group and 80% in the domiciliary group. Morbidity was recorded in 13.8% in the inpatient group, 9.4% in the ESD group and 14.2% in the domiciliary IV group. No mortality was recorded in either group. Thirty-day readmission rates were 13.8% in the inpatient group, 12.5% in the ESD group and 14.2% in the domiciliary group. Total bed days saved was 1443.
  
  
  CONCLUSIONS
  Domiciliary IV antibiotic therapy in bronchiectasis is clinically effective and was safe in our cohort of patients.
authors.affiliation: Centre for Inflammation Research, Queen's Medical Research Institute, Edinburgh, UK.
authors.forename: Pallavi
authors.initials: P
authors.lastname: Bedi
authors.affiliation: Centre for Inflammation Research, Queen's Medical Research Institute, Edinburgh, UK.
authors.forename: Manjit K
authors.initials: MK
authors.lastname: Sidhu
authors.affiliation: Centre for Inflammation Research, Queen's Medical Research Institute, Edinburgh, UK.
authors.forename: Lucienne S
authors.initials: LS
authors.lastname: Donaldson
authors.affiliation: Centre for Inflammation Research, Queen's Medical Research Institute, Edinburgh, UK.
authors.forename: James D
authors.initials: JD
authors.lastname: Chalmers
authors.affiliation: Department of Respiratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.
authors.forename: Maeve P
authors.initials: MP
authors.lastname: Smith
authors.affiliation: Department of Respiratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.
authors.forename: Kim
authors.initials: K
authors.lastname: Turnbull
authors.affiliation: Department of Physiotherapy (Respiratory Medicine), Royal Infirmary of Edinburgh, Edinburgh, UK.
authors.forename: Joanna L
authors.initials: JL
authors.lastname: Pentland
authors.affiliation: Department of Pharmacy (Respiratory Medicine), Royal Infirmary of Edinburgh, Edinburgh, UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Scott
authors.affiliation: 1] Centre for Inflammation Research, Queen's Medical Research Institute, Edinburgh, UK [2] Department of Respiratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.
authors.forename: Adam T
authors.initials: AT
authors.lastname: Hill
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001987:Bronchiectasis / Q000188:drug therapy*; D015331:Cohort Studies; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents