Bakker W, Vinks A A, Mouton J W, de Jonge P, Verzijl J G, Heijerman H G
Ziekenhuis Leyenburg, afd. Longziekten, Centrum voor Volwassen Cystic Fibrosis Patiënten, Den Haag.
Ned Tijdschr Geneeskd. 1993 Nov 27;137(48):2486-91.
To study the feasibility and applicability of Home intravenous antibiotic treatment (HIVAT) in cystic fibrosis (CF) patients in the Netherlands.
Prospective, multicentre study in CF patients with an exacerbation of a Pseudomonas aeruginosa pulmonary infection using a computerised, ambulatory pump for continuous infusion.
The effects of HIVAT were studied during one year in 24 CF patients (9 male, 15 female; mean age 23.3 years, range 7-52), who received a total of 39 courses of continuous ceftazidime 100 mg/kg/24 hrs i.v. for 3 weeks delivered by a pump. The treatment was preceded by a 2-3 days in-hospital instruction period. The treatment was supervised by the clinic without home visits. Clinical data and quality of life questionnaires were collected at the start and at the end of treatment and one month later. Statistical analysis was performed using Wilcoxon's rank-sum test for paired samples.
No major problems were encountered. The patients as well as their physicians preferred home treatment over in-hospital treatment. 35 out of 37 evaluable courses in 23 patients were efficacious. There were statistically significant improvements in clinical condition and quality of life during the treatment. This improvement lasted at least until one month after the end of treatment. The costs of HIVAT were 48-63% less than the same antibiotic treatment in the hospital.
HIVAT was feasible and could be applied without major problems in the Netherlands. It proved safe, efficacious and cost-effective.
