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Presentations on Wednesday,March 21st, 14:00 - 15:30, Amber 1
CPC057 Self-administered home parenteral antibiotic treatment using elastomeric infusion pumps in orthopaedic patients
  1. H. Omestad,
  2. J. Svendsson,
  3. A. Adelfred,
  4. J. Nejatbakhsh,
  5. K. Kjaer-Petersen
  1. 1Aarhus University Hospital Hospital Pharmacy Aarhus Aarhus C, Denmark
  2. 2Aarhus University Hospital, Department of Orthopaedics, Aarhus C, Denmark

Abstract

Background Aarhus Hospital Pharmacy offers portable elastomeric infusion pumps containing dicloxacillin and piperacillin/tazobactam to selected patients. During 2009, The authors documented stability data for both antibiotics in elastomeric infusions pumps. The expiry date for dicloxacillin 10 mg/ml in normal saline (NS) is 4 days at 2-8 °C, and 7 days at 2-8°C followed by 1 day below 32°C for piperacillin/tazobactam 12 g and 16 g in 270 ml NS.

Purpose Infections in bone and joints are treated with intravenous antibiotics for weeks and they need hospitalisation. In order to maintain the patients' physical and social skills and to minimise the need for hospitalisation, a number of selected orthopaedic patients were offered self administration of their parenteral antibiotics at home.

Materials and methods All patients were fitted with a central venous catheter (CVC) and the patient or parent was trained to administer intravenous antibiotics during the period of waiting for the organism identification report. The patients were discharged with all equipment needed and written instructions. Due to the expiry date of the antibiotics, the patients returned to the hospital for new pumps.

Results From August 2009 to April 2011 twelve patients with median age of 37 (1-59) years self-administered their intravenous antibiotics, required due to osteomyelitis (n=10) and septic arthritis (n=3). Two patients received piperacillin/tazobactam and the rest dicloxacillin. Totally intravenous antibiotics were administered for 193 days. The period of self-administration was 133 days, thus decreasing hospital stay by 69 %. One patient developed allergic erythema due to dicloxacillin and was hospitalised and received cefuroxime. All other patients fulfilled their treatment without complications. The patients/parents felt secure and were satisfied with the treatment and preferred the treatment offered over hospitalisation.

Conclusions Self-administration of parenteral antibiotics at home for selected patients can reduce hospital stays significantly. The patients/parents preferred the treatment offered to hospitalisation.

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