Adverse effects of outpatient parenteral antibiotic therapy

被引:94
作者
Hoffman-Terry, ML
Fraimow, HS
Fox, TR
Swift, BG
Wolf, JE
机构
[1] Thomas Jefferson Univ, Dept Med, Div Infect Dis, Philadelphia, PA 19107 USA
[2] Thomas Jefferson Univ Hosp, Home Infus Program, Philadelphia, PA 19107 USA
关键词
D O I
10.1016/S0002-9343(98)00362-3
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
PURPOSE: Although home parenteral antimicrobial therapy has become common, few studies have carefully examined its adverse effects. SUBJECTS AND METHODS: We retrospectively reviewed the medical records of 269 patients who received 291 courses of home parenteral antimicrobial therapy through a hospital-based home infusion program during a 2-year period. Patients with human immunodeficiency virus (HIV) infection were not included. RESULTS: The majority (59%) of patients were treated for bone and joint infections. Patients had a mean age of 47 years. The mean duration of antibiotic therapy was 40 days. Of monitored courses. leukopenia occurred in 16%, neutropenia in 7%, thrombocytopenia in 4%, and eosinophilia in 12%, usually after a month of therapy; these adverse effects were most frequently associated with the use of beta-lactam antibiotics. Nephrotoxicity occurred in 8% of monitored courses at a mean of 27 days and was most commonly associated with amphotericin B. Diarrhea occurred in 7% and rash in 4% of patients, and bath were most commonly seen with beta-lactam antibiotics. Of those patients with permanent indwelling catheters, 11% of those with central catheters and 9% of those with peripherally inserted central catheters (PICCs) developed line complications. Overall, 8% of patients required rehospitalization. CONCLUSION: Home infusion antibiotic therapy exposes patients to the complications associated with inpatient antibiotic therapy and needs to be monitored closely to prevent serious complications and rehospitalizations. Am J Med. 1999;106:44-49. (C) 1999 by Excerpta Medica, Inc.
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页码:44 / 49
页数:6
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