EVALUATION OF THE IMPACT OF NON-INPATIENT IV ANTIBIOTIC-TREATMENT FORACUTE INFECTIONS ON THE HOSPITAL, PRIMARY-CARE SERVICES AND THE PATIENT

The aim of this study was to assess the feasibility of providing iv an tibiotic therapy outside hospital. The main outcome measures were the direct costs of providing iv antibiotic therapy in the community compa red with standard hospital treatment and the perceptions of patients a nd General Practitioners (GPs). A total of 29 patients entered the stu dy, of whom 15 received teicoplanin and 14 ceftriaxone. The costs of d rugs exceeded the cost of the estimated alternative treatments (median pound 208 and pound 126 respectively) and this was only partially com pensated for by a small reduction in costs of consumables. The staff t ime required to train patients was compensated for by savings in drug preparation and administration. Sensitivity analysis showed that these conclusions were sensitive to drug and patient selection, and that tr eatment of skin and soft tissue infections outside hospital with ceftr iaxone was likely to have similar variable costs to treatment in hospi tal with drugs such as flucloxacillin. Non-inpatient iv (NIPIV) therap y was estimated to save a total of 532 bed days in the year of the stu dy. Patients strongly preferred non-inpatient treatment to hospital tr eatment. GPs identified a number of potential disadvantages, mainly co ncerning safety and lack of support for patients at home. Following th e study a strategy for development of NIPIV services in Tayside has be en developed with local GPs and a plan has been agreed for funding a c ommunity liaison nurse based on the impact of NIPIV therapy on future bed requirements in Dundee Teaching Hospitals Trust.