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: Patient s with serious bacterial infections requiring parenteral antibiotic th erapy were enrolled in a pilot program to receive treatment at home. A ntibiotics 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) rece ived 21 courses of intravenous antibiotics at home (mean duration +/-S D, 26 +/-9 days; range, 11-44 days). Conditions treated included osteo myelitis (10 patients), endocarditis (5), vascular graft and pacemaker sepsis (4), and chronic cellulitis (1). Treatment at home was well to lerated 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 inpati ent therapy of at least $112 per day for the 538 days that home therap y was provided. Moreover, the reduced bed use could allow an additiona l hospital throughput of between 86 and 107 patients annually. Conclus ions: Home intravenous antibiotic therapy is safe, effective and well tolerated. It allows more efficient inpatient care and reduces total t reatment costs in an important subpopulation of patients.