Abstract | BACKGROUND: In the tropical north of the Northern Territory, Australia, 25-50 patients are admitted to Royal Darwin Hospital (RDH) each year with Burkholderia pseudomallei infection, or melioidosis. Treatment consists of initial intensive therapy with 2-4 weeks of intravenous antibiotics. Clinical improvement may occur early and patients often prefer to be managed out of hospital in the Hospital in the Home (HITH). OBJECTIVES: To evaluate safety and efficacy of HITH management of patients with melioidosis. METHODS: A prospective observational study of our standard management which consists of 24 h infusions of ceftazidime infused through a peripherally inserted central catheter (PICC) line, plus oral sulphamethoxazole trimethoprim. Treatment is administered in the home, which may be in Darwin, regional areas or remote communities, or in a self-care unit located in the hospital grounds. RESULTS: From February 1998 to December 2001 150 patients were admitted to RDH with culture confirmed B. pseudomallei infection. Of these, 73 patients were treated with 24 h infusions of ceftazidime, of which 70 patients were managed by HITH. Complications of treatment include a PICC line complication rate of 10.6/1000 days in situ. Nine patients had relapse or recrudescence of disease, nearly all as a result of poor adherence to subsequent oral eradication therapy, these patients were all re-treated successfully. One patient remains infected with B. pseudomallei. CONCLUSION: This clinical outcome study suggests that out of hospital management of melioidosis with 24 h infusions of ceftazidime via a PICC line is safe and effective.
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Authors | Sarah Huffam, Susan P Jacups, Paulene Kittler, Bart J Currie |
Journal | Tropical medicine & international health : TM & IH
(Trop Med Int Health)
Vol. 9
Issue 6
Pg. 715-7
(Jun 2004)
ISSN: 1360-2276 [Print] England |
PMID | 15189462
(Publication Type: Journal Article)
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Chemical References |
- Anti-Bacterial Agents
- Ceftazidime
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Topics |
- Adolescent
- Adult
- Aged
- Anti-Bacterial Agents
(administration & dosage)
- Catheterization, Central Venous
(methods)
- Ceftazidime
(administration & dosage)
- Child
- Child, Preschool
- Equipment Failure
- Female
- Home Infusion Therapy
- Humans
- Infusions, Parenteral
(methods)
- Male
- Melioidosis
(drug therapy)
- Middle Aged
- Northern Territory
- Patient Compliance
- Prospective Studies
- Recurrence
- Treatment Outcome
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