Home Intravenous Antimicrobial Infusion Therapy: A Viable Option in Older Adults

Abstract

With appropriate support from a hospital-based home IV antimicrobials therapy team, home IV antimicrobial appears to be a viable option for older adults.

The Community IntraVenous Antibiotic Study (CIVAS): a mixed-methods evaluation of patient preferences for and cost-effectiveness of different service models for delivering outpatient parenteral antimicrobial therapy

“…The initial review in 2013 identified 34 studies that examined patients' acceptability of OPAT, but, of these, 21 were quantitative surveys assessing satisfaction with the service and provided little information about patients' own perceptions of the benefits and disadvantages of OPAT. 5,12,13,15,25,27,36,41,67,68,70,73,[75][76][77][78][80][81][82]86,89 Only six interview-based studies were identified by the review. 35,37,79,85,88,99 The literature indicates that patients generally view OPAT very positively.…”

Tolerability of Cefazolin after Immune-Mediated Hypersensitivity Reactions to Nafcillin in the Outpatient Setting

“…Infections with MSSA are common, with approximately 20% of OPAT program patients and an estimated 400,000 patients in the United States in 2007 alone (38)(39)(40)(41). First-line treatment for MSSA infections includes nafcillin, oxacillin, or cefazolin, with the final decision to use a specific treatment based on provider preference and individual patient-specific factors.…”

Outpatient Parenteral Antimicrobial Therapy Today

“…A recent report of home IV antimicrobial therapy involved 205 patients discharged from a Veterans Affairs tertiary care medical center that had an infectious diseases clinic, including a trained outpatient IV infusion team [13]. During the 3.5 years (July 2000 through December 2003) of the study, patients received 231 courses of home IV antimicrobials: 107 among those aged у60 (mean age, 69) and 124 among those aged !60 years (mean age, 51).…”

“…The most common indications for therapy were osteoarticular infection (52%), bacteremia (14%), and skin and softtissue infections (13%) [13]. Staphylococcus aureus was the predominant pathogen (39% of all episodes).…”

“…A member of the IV therapy team, who verified that patients could safely perform infusions at home, instructed patients, their families, or other caregivers in infusion techniques [13]. Patients and their families assumed responsibility for storage and mixing of the antimicrobial agents, infusion of the drug, flushing of the catheter, and daily observation of the catheter site.…”