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Wiley InterScience

Journal of the American Geriatrics Society

Journal of the American Geriatrics Society

Volume 55 Issue 5, Pages 645 - 650

Published Online: 20 Mar 2007

Journal compilation 2010 The American Geriatrics Society/Wiley Periodicals, Inc.



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CLINICAL INVESTIGATIONS
Home Intravenous Antimicrobial Infusion Therapy: A Viable Option in Older Adults
(See editorial comments by Dr. Kevin High on pp 792–793)
Amanda M. Cox, MD * , Preeti N. Malani, MD †‡§ , Stephen W. Wiseman, PharmD , and Carol A. Kauffman, MD
From the Divisions of  *General Medicine,  Infectious Diseases, and  Geriatric Medicine, Department of Internal Medicine,  §Geriatric Research Education and Clinical Center, and  Department of Pharmacy Services, Veterans Affairs Ann Arbor Healthcare System, University of Michigan Health System, Ann Arbor, Michigan.
 Address correspondence to Dr. Preeti N. Malani, VA Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105. E-mail: pmalani@umich.edu
Copyright © 2007, The American Geriatrics Society
KEYWORDS
elderly • older adults • home infusion • antimicrobial agents

ABSTRACT

OBJECTIVES: To 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.

DESIGN: Retrospective cohort study.

SETTING: Veterans Affairs Ann Arbor Healthcare System, a 100-bed tertiary care medical center.

PARTICIPANTS: All patients who received home IV antimicrobials from July 1, 2000, through December 31, 2003.

MEASUREMENTS: Demographic 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.

RESULTS: A 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).

CONCLUSION: With appropriate support from a hospital-based home IV antimicrobials therapy team, home IV antimicrobial appears to be a viable option for older adults.


DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1532-5415.2007.01133.x About DOI

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