Home Intravenous Antimicrobial Infusion Therapy: A Viable Option in Older Adults(See editorial comments by Dr. Kevin High on pp 792–793)


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Abstract

OBJECTIVESTo determine whether older adults and younger adults are equally able to administer home intravenous antimicrobial infusion therapy (home IV antimicrobials) without intensive support from home care agencies.DESIGNRetrospective cohort study.SETTINGVeterans Affairs Ann Arbor Healthcare System, a 100-bed tertiary care medical center.PARTICIPANTSAll patients who received home IV antimicrobials from July 1, 2000, through December 31, 2003.MEASUREMENTSDemographic data, underlying medical conditions, indications for therapy, antimicrobial agents administered, concomitant medications, frequency of patient visits and phone calls, adverse events, and outcomes of infections.RESULTSA total of 205 patients received 231 courses of home IV antimicrobials, with 107 courses in patients aged 60 and older and 124 courses in patients younger than 60. For both groups, the most common indication for therapy was osteoarticular infections, and the predominant pathogens were Staphylococcus aureus and coagulase-negative Staphylococcus. Older patients were significantly more likely than younger patients to require the assistance of family members to help with the infusion and were more likely to be seen in urgent care or to call the infectious diseases pharmacist or physicians with questions. Overall, clinical outcomes and numbers of adverse events were similar in both groups, with the exception of nephrotoxicity, which was greater in the older group (P=.02).CONCLUSIONWith appropriate support from a hospital-based home IV antimicrobials therapy team, home IV antimicrobial appears to be a viable option for older adults.

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