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Journal of Antimicrobial Chemotherapy (1996) 37, 1023-1029
© 1996 The British Society for Antimicrobial Chemotherapy

research-article

Safe intravenous antibiotic therapy at home: experience of a UK based programme

J. Kayleya, A. R. Berendtb, M. J. M. Snellingc, H. Moorea, H. C. Hamiltond, T. E. A. Petob, D. W. M. Crooke and C. P. Conlonb,*

aCommunity Nursing, East Oxford Health Centre Oxford bInfectious Diseases Unit, Nuffield Department of Medicine, Oxford Radcliffe Hospital Headley Way, Oxford OX3 9DU, UK cPharmacy Department, Churchill Hospital Oxford dTPN Service, Department of Surgery, Oxford Radcliffe Hospital Headley Way, Oxford OX3 9DU, UK eDepartment of Microbiology, Oxford Radcliffe Hospital Headley Way, Oxford OX3 9DU, UK

Received 26 September 1995; accepted 18 December 1995

*Corresponding author

Outpatient iv antibiotic therapy is well developed in the United States, largely because of pressures from third-party payers to reduce costs of medical care. We have developed an outpatient iv antibiotic programme in Oxford, that has evolved from a desire to provide high quality iv therapy to AIDS patients with cytomegalovirus retinitis. We describe the rationale of the service and report on our first two years' experience. We treated 67 consecutive patients (eight with HIV infection) at home with iv antibiotics. This resulted in a saving of 2275 hospital days for those patients without HIV infection. HIV positive patients received 69 months of home iv therapy. Minor intravascular catheter complications occurred in only five patients (7.5%). The only serious complications were three episodes of catheter-related sepsis (4.5%), all occurring in AIDS patients who had lines in for more than six months.

We have shown that home iv antibiotic therapy can be delivered safely to patients with a wide variety of infectious problems using the existing network of community nurses in the National Health Service. Essential components to the programme include a multidisciplinary team working between the hospital and community and a written shared care protocol. Such a programme can result in reduced lengths of hospital stay and patient, community nurse and physician satisfaction.


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