Safety and efficacy of home intravenous antimicrobial infusion therapy in older patients: a comparative study with younger patients

Pérez‐López, Jordi; Laporte, Antonio San José; Pardos-Gea, José; Melenchón, E. Tapia; Ortín, E. Lozano; Guirado, A. Barrio; Tarrés, Miquel Vilardell

doi:10.1111/j.1742-1241.2008.01747.x

Cited by 31 publications

(41 citation statements)

References 23 publications

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“…Also, age was not associated with an increased rate of CVC complications or likelihood of readmissions, as in other studies showing that age was not associated with CLABSI, 28,29 CVC occlusion, 28 other line events, 29 or readmissions. 30–33 …”

Section: Discussionmentioning

confidence: 99%

Environmental Exposures and the Risk of Central Venous Catheter Complications and Readmissions in Home Infusion Therapy Patients

Keller

Williams²,

Gavgani³

et al. 2016

Infect. Control Hosp. Epidemiol.

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BACKGROUND Patients are frequently discharged with central venous catheters (CVCs) for home infusion therapy. OBJECTIVE To study a prospective cohort of patients receiving home infusion therapy to identify environmental and other risk factors for complications. DESIGN Prospective cohort study between March and December 2015. SETTING Home infusion therapy after discharge from academic medical centers. PARTICIPANTS Of 368 eligible patients discharged from 2 academic hospitals to home with peripherally inserted central catheters and tunneled CVCs, 222 consented. Patients remained in the study until 30 days after CVC removal. METHODS Patients underwent chart abstraction and monthly telephone surveys while the CVC was in place, focusing on complications and environmental exposures. Multivariable analyses estimated adjusted odds ratios and adjusted incident rate ratios between clinical, demographic, and environmental risk factors and 30-day readmissions or CVC complications. RESULTS Of 222 patients, total parenteral nutrition was associated with increased 30-day readmissions (adjusted odds ratio, 4.80 [95% CI, 1.51–15.21) and CVC complications (adjusted odds ratio, 2.41 [95% CI, 1.09–5.33]). Exposure to soil through gardening or yard work was associated with a decreased likelihood of readmissions (adjusted odds ratio, 0.09 [95% CI, 0.01–0.74]). Other environmental exposures were not associated with CVC complications. CONCLUSIONS complications and readmissions were common and associated with the use of total parenteral nutrition. Common environmental exposures (well water, cooking with raw meat, or pets) did not increase the rate of CVC complications, whereas soil exposures were associated with decreased readmissions. Interventions to decrease home CVC complications should focus on total parenteral nutrition patients.

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Section: Discussionmentioning

confidence: 99%

Environmental Exposures and the Risk of Central Venous Catheter Complications and Readmissions in Home Infusion Therapy Patients

Keller

Williams²,

Gavgani³

et al. 2016

Infect. Control Hosp. Epidemiol.

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“…The increasing knowledge of their safety for the treatment of a large variety of infectious diseases has prompted the creation of reference therapeutic guidelines like those compiled by the American Society of Infectious Diseases 1213. These programs have advantages that span all age groups: elderly patients benefit because these programs reduce the incidence of many adverse events resulting from conventional hospitalization, including delirium and functional worsening, and young patients benefit by having more freedom through resuming a normal lifestyle 14–17…”

Section: Discussionmentioning

confidence: 99%

Home intravenous antibiotics in a tertiary care hospital in Saudi Arabia

Baharoon

Almodaimeg

Watban

et al. 2011

Annals of Saudi Medicine

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BACKGROUND AND OBJECTIVE:Home intravenous (IV) antibiotic programs are becoming increasingly popular worldwide because of their efficacy and safety. However, in Saudi Arabia these programs have not yet become an integrated part of the health care system. We present our experience with a home IV antibiotic program, as one of the major health care providers in Saudi Arabia.DESIGN AND SETTING:Retrospective chart review of patients enrolled in the King Abdulaziz Medical City Home Health Care IV Antibiotic Program from 1 May 2005 (the start of the program) until 30 December 2007.METHODS:In addition to demographic characteristics, we collected data on the site of infection, the clinical diagnosis, the isolated microorganisms, and the type of antibiotics given. Outcome measures evaluated included the relapse rate, failure rate, the safety of the program, and readmission rates.RESULTS:Of the 155 patients enrolled, 152 patients completed the program. Those who completed the program had a mean (SD) age of 52.8 (23.9) years. The mean (SD) duration of the IV antibiotic treatment was 20.6 (17) days. Three patients refused to complete the intended duration of therapy. Peripherally inserted central catheter (PICC) lines were utilized in 130 patients (86%). One-hundred and thirty-one patients completed the intended duration of therapy, although the therapy was changed from the initial plan for 21 (13.8%) patients. Readmission to the hospital during therapy was required for 13 patients (8.5%). Osteomyelitis was the most frequently encountered diagnosis (65 patients, 42.8%), followed by urinary tract infection (36 patients, 23.7%).CONCLUSIONS:The home health care-based IV antibiotic program was an effective and safe alternative for in-patient management of patients with non-life-threatening infections, and was associated with a very low complication rate. Home IV antibiotic programs should be used more frequently as part of the health care system in Saudi Arabia.

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“…The advantages of HITH or OPAT include efficient usage of hospital bed facilities, high patient satisfaction, minimised nosocomial infections, reduced mortality, reduced readmissions and cost‐effectiveness . However, the challenges of HITH or OPAT cannot be under‐estimated: these include limited support by nursing staff or the physician at home and the potential for complications not to be monitored or attended to immediately .…”

Section: Introductionmentioning

confidence: 99%

Safety and effectiveness of ‘hospital in the home’ and ‘outpatient parenteral antimicrobial therapy’ in different age groups: A systematic review of observational studies

et al. 2018

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Safety and efficacy of home intravenous antimicrobial infusion therapy in older patients: a comparative study with younger patients

Abstract: Home intravenous antimicrobial infusion therapy in elderly patients is safe and effective.

Cited by 31 publications

References 23 publications

Environmental Exposures and the Risk of Central Venous Catheter Complications and Readmissions in Home Infusion Therapy Patients

Environmental Exposures and the Risk of Central Venous Catheter Complications and Readmissions in Home Infusion Therapy Patients

Home intravenous antibiotics in a tertiary care hospital in Saudi Arabia

Safety and effectiveness of ‘hospital in the home’ and ‘outpatient parenteral antimicrobial therapy’ in different age groups: A systematic review of observational studies

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