Safety of continuous antibiotic infusions administered through an Australian hospital in the home service: a pilot study

BackgroundFew studies have assessed the safety of antibiotic infusions in the hospital in the home (HITH) setting, or the vascular access and ambulatory infusion devices used for delivering these infusions.AimTo explore treatments and health outcomes for HITH patients administered continuous antibiotic infusions through an ambulatory infusion device.MethodCase notes for patients managed by a HITH service affiliated with a large metropolitan hospital were retrospectively audited. Consecutive patients treated for cellulitis, osteomyelitis, endocarditis, diabetic foot infection or septic arthritis between January and September 2014, and receiving intravenous antibiotic therapy through an ambulatory infusion device, were included. Patients were followed until discharge from HITH to determine adverse outcomes related to antibiotic therapy, including administration devices.ResultsThe audit recruited 31 patients with a median age of 62 years; 17 (55%) were male. Overall 14 adverse events were experienced by 10 (32%) patients. Of the 14 adverse events, nine (64%) were medication-related, one (7%) related to a vascular access device and four (29%) were infusion device-related. Therapeutic failure occurred in four patients; three were re-hospitalised; and one had their therapy extended. Most patients had an infusion that was identified as not running to completion on at least one occasion at the time of their home visit (81%), or problems with flushing lines or aspirating blood from the vascular access devices (35%).ConclusionAdverse events were commonly observed among patients receiving continuous antibiotic infusions in this pilot study. Further research is needed to identify patients at risk of adverse events.