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Rapid Responses: Rapid Responses published:
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Home antibiotic treatment
- Ian N Miskin (20 June 2007)
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Ian N Miskin, Community infectious dis. consultant Jerusalem, Israel
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Dear sirs, I read the Cystic Fibrosis patient odyssey with great interest. I am a family practitioner and consultant in infectious disease. I work together with a specialist CF clinic in Jerusalem providing home intravenous antibiotic care. This requires iv access, which can be short- or long term (if short term access is the responsibility of the local GP). Antibiotics are provided by the HMO to one of two companies that package them ready-to-use and deliver them to the patient's address together with neccessary heparin and saline flushes and other disposables. Most antibiotics are delivered once weekly and can remain non-refrigerated for up to 24 hours. This enables once daily continuous delivery for beta- lactams, and as the drug delivery does not require gravitation the system can be carried around in a pouch. When required, we are able to supply those antibiotics which can be used only within 50 hours of reconstitution, these are delivered every two days. We are able to provide home antibiotics within 6 hours of request. Patients and families are taught (usually in no more than 30 minutes) how to connect and disconnect the lines, and also the danger signs. They are responsible for this part of the treatment, a specialist nurse is on call for telephone advice, and usually inspects the lines weekly. I can sum up by saying that in the Jerusalem area no patients are hospitalised merely to receive antibiotic therapy. Ian Miskin MD, Clalit health services, Jerusalem, Israel [As an employee of the HMO I have no financial interest, however I feel that this low technology solution should be widely available in the UK] Competing interests: None declared |
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