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-administered by 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.
|Publication status||Published - 1 Feb 2013|
- Anti-infective agents
- Elastomeric infusion pump
- Emergency health services
- Home care services, hospital based