Summary
Safety and efficacy of home intravenous antibiotic therapy for patients referred by the hospital emergency department
Mujal Martínez A, Solá Aznar J, Hernández Ávila M, Aragüás Flores C, Machado Sicilia ML, Oristrell Salvá J
Affiliation of the authors
Hospital de Sabadell. Institut Universitari Parc Taulí, Sabadell, Universitat Autònoma de Barcelona, Barcelona, Spain.
DOI
Quote
Mujal Martínez A, Solá Aznar J, Hernández Ávila M, Aragüás Flores C, Machado Sicilia ML, Oristrell Salvá J. Safety and efficacy of home intravenous antibiotic therapy for patients referred by the hospital emergency department. Emergencias. 2013;25:31-6
Summary
Objective: To analyze the safety and efficacy of home intravenous antibiotic therapy
(HIVAT) for patients with infections discharged from the emergency department and
referred to the home hospital program.
Methods: Prospective study of patients referred to the home hospital program of
Hospital de Sabadell for HIVAT between January 2008 and June 2011. We compared 2
groups: patients referred by the emergency department and patients referred by any
other department or service. Variables analyzed included age, sex, mean stay in the
program, Barthel index, route and method for administering the antibiotic, type of
infection, microorganism isolated, antibiotic prescribed, early and late readmission rates,
and complications (medical and those associated with venous access). HIVAT was self administer eby the patient (or home caregiver) through an elastomeric infusion device.
Results: We studied 409 patients and 492 courses of HIVAT; 92 patients were referred by
the emergency department and 400 came from other care units. Emergency patients were
older, had greater functional impairment, a shorter stay in the program, a higher rate of
urinary tract infection, and a lower rate of Pseudomonas aeruginosa infection. Referral from the emergency department was not associated with higher risk of readmission to hospital, worse infection course or outcome, or development of a health-care-associated infection.
Conclusions: Self-administered HIVAT is safe and effective for patients discharged from
emergency care. This therapeutic option is not associated with a worse course of
infection or higher rates of hospital readmission for emergency patients in comparison
with those referred by other departments.