Home intravenous
antibiotic therapy is an alternative to hospital admission for moderately severe
infections. However, few studies have analyzed its safety and effectiveness in the treatment of
infections caused by multidrug-resistant bacteria. The purpose of this study is to analyze the safety and effectiveness of home intravenous
antibiotic therapy in multidrug-resistant
bacterial infections. We analyzed prospectively all patients admitted to our service who underwent home intravenous
antibiotic therapy during the period 2008-2012. All the treatments were administered by caretakers or self-administered by patients, through elastomeric infusion devices. Effectiveness was evaluated by analyzing the readmission rate for poor infection control. Safety was evaluated by analyzing adverse events,
catheter-related complications, and readmissions not related to poor infection control. There were 433 admissions (in 355 patients) for home intravenous
antibiotic therapy during the study period. There were 226 (52.2 %) admissions due to multidrug-resistant
bacterial infections and 207 (47.8 %) due to non-multidrug-resistant
infections.
Hospital readmissions in patients with multidrug-resistant
infections were uncommon. Multidrug-resistant enterococcal
infections, healthcare-associated infections, and
carbapenem therapy were independent variables associated with increased readmissions due to poor infection control. Readmissions not related to poor infection control, adverse events, and
catheter-related complications were similar in multidrug-resistant compared to non-multidrug-resistant
bacterial infections. Home intravenous
therapy, administered by patients or their caretakers using elastomeric
infusion pumps, was safe and effective for the treatment of most multidrug-resistant
bacterial infections.