van den Broek P J, Haerkens H M, van Weert N J, Vermeij P
Afd. Infectieziekten, Academisch Ziekenhuis, Leiden.
Ned Tijdschr Geneeskd. 1997 Nov 22;141(47):2297-301.
To determine whether intravenous home treatment with antimicrobial drugs of patients with an infection is feasible.
Descriptive.
Academic Hospital, Leiden, the Netherlands.
In October 1992 a programme for intravenous home treatment of patients with infectious diseases was started. The programme was based on self-administration of the intravenous antibiotic therapy by the patient. The hospital pharmacy provided the antibiotics and infusion devices, an infectious diseases specialist supervised the home treatment and the nursing staff of the First Aid Department was available to change infusion cannulas. After assessment of their medical and psychosocial fitness in which the general practitioner was involved, thorough instruction on use of the infusion device and care of the infusion cannula, patients were sent home.
In the period October 1992-September 1996, 162 patients (median age: 45.0 years (range: 3-82)) were treated at home for a median period of 15 days (1-221). Osteomyelitis, arthritis, Lyme disease, septicaemia with secondary foci, and herpes virus infections were the most frequent indications for home treatment. Penicillins and cephalosporins were given in 70% of the cases, teicoplanin and antiviral drugs in 12% and 14%, respectively. For intermittent administration bolus injection, a mechanical or elastomeric pump were used, for continuous infusion a syringe or cassette pump. The intention of the programme that the patient performed the home treatment as much as possible without extra professional help, was realised in 82% of the patients. In 60% of the cases the patients were fully self supporting, in 22% family or friends played an important role.
Home treatment with antimicrobial drugs intravenously is quite feasible. If this were fully implemented, about 1400 patients in the Netherlands could be treated in this manner.
确定对感染患者进行静脉抗菌药物家庭治疗是否可行。
描述性研究。
荷兰莱顿的学术医院。
1992年10月启动了一项针对传染病患者的静脉家庭治疗计划。该计划基于患者自行进行静脉抗生素治疗。医院药房提供抗生素和输液设备，传染病专家监督家庭治疗，急救部门的护理人员负责更换输液套管。在由全科医生参与评估患者的医疗和心理社会状况、对输液设备的使用和输液套管的护理进行全面指导后，患者被送回家。
在1992年10月至1996年9月期间，162名患者（中位年龄：45.0岁（范围：3 - 82岁））在家接受治疗，中位治疗时间为15天（1 - 221天）。骨髓炎、关节炎、莱姆病、伴有继发灶的败血症和疱疹病毒感染是最常见的家庭治疗适应证。70%的病例使用了青霉素和头孢菌素，替考拉宁和抗病毒药物分别占12%和14%。间歇性给药采用大剂量注射时，使用机械泵或弹性泵，持续输注时使用注射器泵或盒式泵。该计划的目标是患者在没有额外专业帮助的情况下尽可能多地进行家庭治疗，82%的患者实现了这一目标。60%的病例中患者完全能够自理，22%的病例中家人或朋友发挥了重要作用。
静脉抗菌药物家庭治疗是相当可行的。如果全面实施，荷兰约1400名患者可以采用这种方式治疗。
