Home Intravenous Antibiotic Therapy: New Technologies

Abstract

Over the past 15 years, an increasing variety of intravenous (IV) therapies have been administered to patients both at home and in the outpatient setting. Intravenous anti-infective and chemotherapeutic agents, analgesics, blood product and coagulation factor replacement, immunoglobulins, and even positive inotropic drugs [12] have been safely and effectively administered at home. All of these therapeutic modalities share a number of characteristics including the need for an integrated team approach (physicians, pharmacists, and nurses), careful inclusion and exclusion criteria, a structured follow up process, and increased responsibility on the patient’s part for self-care. [17] In the United States, the increased interest in, and availability of, structured home care infusion services (both hospital- and home-based), new venous access devices, the increased emphasis on the economic aspects of health care provision, and the development of a variety of new infusion technologies, have enabled more patients to be appropriately and conveniently treated with home or outpatient IV antibiotics. In most instances, either the patient or someone in the home (parent, spouse, or other support person) administers the IV drug. In Europe, potential barriers to the implementation of home IV antibiotic services include such issues as who may legally administer IV drugs, the availability of trained staff, and financial reimbursement for such services. Structural and legal issues may differ between countries.