The Midline Catheter Within the Context of Home Intravenous Antibiotic Treatment

Abstract

Home intravenous antibiotic treatment (HIAT) consists of the administration of intravenous antibiotic therapy in the home of the patient. Short peripheral intravenous catheters have long been the first option for antimicrobial therapies. However, these devices are known for their short durability. At present, the midline catheter is one of the median duration devices most commonly used and recommended within the context of HIAT. The objective of this study was to evaluate the occurrence of complications related to midline catheters implanted by a vascular access team in patients undergoing HIAT within the context of home hospitalization. This was a prospective observational study, which consecutively included 77 patients. A total of 92 midline catheters were analyzed. The complications observed were device obstruction (8.7%), infiltration (3.3%), dislodgement (2.2%), and thrombosis (1.1%). Bivariate analysis showed that the pH of the drug and ertapenem administration were associated with catheter obstruction. The authors found a low prevalence of midline catheter-associated complications in patients undergoing HIAT. The use of antireflux needleless connectors should be considered to reduce obstructions. In addition, algorithms that include the variable of type of daily life activity should be developed for deciding the most appropriate catheter for home hospitalized patients receiving HIAT.