A number of
antimicrobial agents have been used successfully to treat patients with chronic
infectious diseases in the home health care environment. This diversity in types of
antibiotics used reflects more than ten years' development of active home medical care programs. With continuing experience, it is clear that the number and types of
antibiotics available on formulary for routine use in home programs can be condensed. Since a patient should in most cases be treated in the home environment with the same
antibiotic that has demonstrated efficacy and safety upon initial
therapy during hospitalization, the selection of available
antibiotics will affect the hospital's formulary selection process. This process must critically evaluate the documented efficacy and safety of each agent, since the
drug's primary use will be in a relatively uncontrolled environment, devoid of continuous professional assessment. The
beta-lactam antibiotics appear to be preferred agents for outpatient use, particularly as monotherapy. These agents offer desirable in vitro activity and potency, ease of administration, overall efficacy, and safety. However, despite a preference for
beta-lactam antibiotics, additional and alternative agents must be routinely available in program formularies.