Journal of Antimicrobial Chemotherapy, Vol 42, 373-380, Copyright © 1998 by The British Society for Antimicrobial Chemotherapy
SE Parker, D Nathwani, D O'Reilly, S Parkinson and PG Davey
The aim of this study was to assess the feasibility of providing i.v.
antibiotic therapy outside hospital. The main outcome measures were the
direct costs of providing i.v. antibiotic therapy in the community compared
with standard hospital treatment and the perceptions of patients and
General Practitioners (GPs). A total of 29 patients entered the study, of
whom 15 received teicoplanin and 14 ceftriaxone. The costs of drugs
exceeded the cost of the estimated alternative treatments (median Pound
Sterling 208 and Pound Sterling 126 respectively) and this was only
partially compensated for by a small reduction in costs of consumables. The
staff time 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
treatment of skin and soft tissue infections outside hospital with
ceftriaxone was likely to have similar variable costs to treatment in
hospital with drugs such as flucloxacillin. Non-inpatient i.v. (NIPIV)
therapy was estimated to save a total of 532 bed days in the year of the
study. Patients strongly preferred non-inpatient treatment to hospital
treatment. GPs identified a number of potential disadvantages, mainly
concerning safety and lack of support for patients at home. Following the
study a strategy for development of NIPIV services in Tayside has been
developed with local GPs and a plan has been agreed for funding a community
liaison nurse based on the impact of NIPIV therapy on future bed
requirements in Dundee Teaching Hospitals Trust.
ORIGINAL ARTICLES
Evaluation of the impact of non-inpatient i.v. antibiotic treatment for acute infections on the hospital, primary care services and the patient
Department of Clinical Pharmacology, Ninewells Hospital, Dundee Teaching Hospitals NHS Trust, UK.
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