[Translated article] Retrospective study of home antibiotic infusion therapy using elastomeric infusion pumps.

Antibiotic Home infusion therapy Infusion pumps antibiótico bombas de infusión terapia de infusión domiciliaria

Journal

Farmacia hospitalaria : organo oficial de expresion cientifica de la Sociedad Espanola de Farmacia Hospitalaria
ISSN: 2171-8695
Titre abrégé: Farm Hosp
Pays: Spain
ID NLM: 9440679

Informations de publication

Date de publication:
27 Apr 2024
Historique:
received: 31 05 2023
revised: 17 12 2023
accepted: 26 12 2023
medline: 29 4 2024
pubmed: 29 4 2024
entrez: 28 4 2024
Statut: aheadofprint

Résumé

To describe the experience of home antibiotic infusion therapy using elastomeric infusion pumps, administered to patients admitted to the Home Hospitalisation Unit of a tertiary hospital for 3 years and to analyse clinical evolution and mortality. Retrospective observational study. The medical history of the patients included in the study was reviewed. Information was obtained on personal history, antimicrobial therapy received, and clinical evolution. Statistical analysis was performed using SPSS® 19 software. 81 patients were included, 61.7% men, with a mean age of 73.5±17.5 years. The most frequent comorbidities were diabetes mellitus (30.9%) and chronic kidney disease (28.4%). Patients received a mean of 11.9±8.5 days of antibiotic treatment in an elastomeric infusion pump. The main focus of infection was respiratory (27.2%), followed by bacteremia (16%) and skin and soft tissue infections (12.3%). Of the infections, 65.4% were monomicrobial, with Pseudomonas aeruginosa being the main microorganism involved (39.6%). The most commonly used antimicrobial was piperacillin/tazobactam (33.3%). The clinical course was good in 85.2% of the patients, but the mortality rate in the 30 days following the end of treatment was 24.7%. In the univariate analysis, a history of neoplasia in the last 5 years (p=.01) and having received fewer days of antibiotic therapy prior to the start of outpatient antimicrobial therapy in infusion pump (p=.04) were associated with worse clinical outcome. Age over 80 years was associated with better outcome (p=.03). The diagnosis of heart failure was associated with higher mortality (p=.026) and patients from surgical services, with lower mortality (p=.047). In the multivariate analysis, the presence of neoplasia was associated with unfavourable evolution (p=.012) and heart failure with higher mortality (p=.027). Outpatient antimicrobial therapy in elastomeric infusion pumps is an alternative in patients requiring prolonged intravenous treatment, and age is not a conditioning factor for inclusion in these programs. However, the presence of certain comorbidities can negatively affect the clinical course and mortality of patients.

Identifiants

pubmed: 38679534
pii: S1130-6343(24)00047-3
doi: 10.1016/j.farma.2024.03.011
pii:
doi:

Types de publication

Journal Article

Langues

eng spa

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Publicado por Elsevier España, S.L.U.

Déclaration de conflit d'intérêts

Declaration of competing interest None declared.

Auteurs

Sara Ferro Rodríguez (S)

Servicio de Farmacia, Complejo Hospitalario Universitario de Lugo, Lugo, Spain. Electronic address: saraferrorodriguez@gmail.com.

Yelco Chantres Legaspi (Y)

Servicio de Medicina Interna, Complejo Hospitalario Universitario de Lugo, Lugo, Spain.

Eva María Romay Lema (EM)

Servicio de Enfermedades Infecciosas, Complejo Hospitalario Universitario de Lugo, Lugo, Spain.

Blanca Ayuso García (B)

Servicio de Enfermedades Infecciosas, Complejo Hospitalario Universitario de Lugo, Lugo, Spain.

Paloma Castellano Copa (P)

Servicio de Farmacia, Complejo Hospitalario Universitario de Lugo, Lugo, Spain.

Pedro Peinó Camba (P)

Servicio de Medicina Interna, Complejo Hospitalario Universitario de Lugo, Lugo, Spain.

Andrea Barcia Losada (A)

Servicio de Hospitalización a Domicilio, Complejo Hospitalario Universitario de Lugo, Lugo, Spain.

Cristina Rodríguez Díaz (C)

Servicio de Hospitalización a Domicilio, Complejo Hospitalario Universitario de Lugo, Lugo, Spain.

Classifications MeSH