[Favorable results with intravenous antimicrobial therapy outside the hospital].

OBJECTIVE

To determine whether intravenous home treatment with antimicrobial drugs of patients with an infection is feasible.

DESIGN

Descriptive.

SETTING

Academic Hospital, Leiden, the Netherlands.

METHODS

In October 1992 a programme for intravenous home treatment of patients with infectious diseases was started. The programme was based on self-administration of the intravenous antibiotic therapy by the patient. The hospital pharmacy provided the antibiotics and infusion devices, an infectious diseases specialist supervised the home treatment and the nursing staff of the First Aid Department was available to change infusion cannulas. After assessment of their medical and psychosocial fitness in which the general practitioner was involved, thorough instruction on use of the infusion device and care of the infusion cannula, patients were sent home.

RESULTS

In the period October 1992-September 1996, 162 patients (median age: 45.0 years (range: 3-82)) were treated at home for a median period of 15 days (1-221). Osteomyelitis, arthritis, Lyme disease, septicaemia with secondary foci, and herpes virus infections were the most frequent indications for home treatment. Penicillins and cephalosporins were given in 70% of the cases, teicoplanin and antiviral drugs in 12% and 14%, respectively. For intermittent administration bolus injection, a mechanical or elastomeric pump were used, for continuous infusion a syringe or cassette pump. The intention of the programme that the patient performed the home treatment as much as possible without extra professional help, was realised in 82% of the patients. In 60% of the cases the patients were fully self supporting, in 22% family or friends played an important role.

CONCLUSION

Home treatment with antimicrobial drugs intravenously is quite feasible. If this were fully implemented, about 1400 patients in the Netherlands could be treated in this manner.