Eron L J
Division of Infectious Diseases, Fairfax Hospital, Falls Church, Va.
Chemotherapy. 1991;37 Suppl 2:14-20. doi: 10.1159/000238914.
Antibiotics can be administered parenterally to outpatients in order to achieve adequate serum levels to treat such infections as endocarditis, osteomyelitis and diabetic foot infections, and to eradicate such difficult-to-treat organisms as methicillin-resistant Staphylococcus aureus, cephalothin-resistant gram-negative bacilli and invasive fungal infections. At Intracare, a free-standing clinic for such therapy, 3,247 outpatients have been treated to date. Besides the type of infection, criteria for patient selection include improvement in the patient's condition, a desire to leave the hospital, an adequate support structure at home, patient compliance and adequate insurance coverage. The most frequently treated infections have been osteomyelitis, followed by infection of skin and skin structure. Ceftriaxone and cefazolin are the two most frequently utilized antibiotics. The program at Intracare is used to examine such issues of quality assurance as patient compliance, therapeutic outcome, adverse events and patient satisfaction in this largely unregulated multibillion dollar industry. It is likely that such infusion centers will evolve into protohospitals, day care centers for present-day medical-surgical patients not occupying intensive care beds.
抗生素可通过肠胃外途径给予门诊患者，以达到足够的血清水平，从而治疗心内膜炎、骨髓炎和糖尿病足感染等感染，并根除耐甲氧西林金黄色葡萄球菌、耐头孢噻吩革兰氏阴性杆菌和侵袭性真菌感染等难以治疗的病原体。在Intracare这家专门进行此类治疗的独立诊所，迄今为止已治疗了3247名门诊患者。除感染类型外，患者选择标准还包括患者病情的改善、出院意愿、家中有足够的支持体系、患者的依从性以及足够的保险覆盖范围。最常治疗的感染是骨髓炎，其次是皮肤及皮肤结构感染。头孢曲松和头孢唑林是最常用的两种抗生素。Intracare的项目用于在这个基本上不受监管、价值数十亿美元的行业中，检查患者依从性、治疗结果、不良事件和患者满意度等质量保证问题。这类输液中心很可能会发展成为原始医院，即现今不占用重症监护床位的内科-外科患者的日间护理中心。
