EXPERIENCE WITH TEICOPLANIN IN NON-INPATIENT THERAPY IN CHILDREN WITHCENTRAL LINE INFECTIONS

Indwelling intravenous catheters are an invaluable part of the curativ e therapy or terminal care of children with haematological malignancie s. The increase in their use has been paralleled by an increase in Gra m-positive infections, however. This article provides an overview of n on-inpatient treatment of central line infections using teicoplanin. T he main drivers for considering non-inpatient therapy were to increase the quality of the patient's life by reducing the amount of time spen t in hospital, and to prolong the life of the catheter. A large propor tion (95%) of the children in the unit described have indwelling cathe ters in situ, including Port-a-caths, Hickman catheters and Vascaths. The indications suitable for non-inpatient antibiotic therapy of line infections were those patients near the end of their chemotherapy cour ses, during terminal care, in non-neutropenic patients to complete an antibiotic course, and in patients with chronically neutropenic aplast ic anaemia. Persistent line infections are not always eradicated but u sually controlled. Care can take place in the home, in the general pra ctitioner (GP) surgery or in the outpatient clinic. Care can be undert aken by nurses, older patients and parents. Follow-up procedures are i n place to ensure safe, effective therapy.