Ambulatory antibiotic infusion devices: extending the spectrum of outpatient therapies

Abstract

Study objective: To examine the safety and efficacy, as well as the economic impact, of outpatient intravenous antibiotic administration using an ambulatory infusion pump.

Design: Retrospective analysis of patients treated through a single home care pharmacy.

Setting: General community and skilled nursing facilities of the greater Monterey (California) area.

Patients: Ninety-eight consecutive patients with infections requiring parenteral antibiotics, treated outside the acute-care setting and not eligible for traditional intravenous minibag administration.

Interventions: Patients received intravenous antibiotics either in the home setting (86%) or in skilled nursing facilities (11%) using a Pharmacia Deltec CADD-VT ambulatory infusion device.

Measurements and main results: Between April 1, 1986, and July 30, 1988, 98 patients received parenteral antibiotics using an infusion pump, and complete data were available on 96 (98%). A total of 109 treatment courses were given over 1,917 treatment days, with a mean duration of therapy of 18 days. Twenty-three different infections were treated by the use of 12 separate antibiotics. The most common complications included vein irritation (11%) and the inability to maintain venous access (6.2%). Therapy costs were equivalent to or less than the intravenous minibag system depending on the frequency of antibiotic administration. Eighty percent of patients experienced successful resolution of their infection.

Conclusions: Ambulatory antibiotic infusion pumps can be used safely and effectively in the outpatient setting. Use of these pumps should increase the number of patients eligible for out-of-hospital treatment, resulting in a marked reduction in treatment costs.