Background: Pediatric home care has improved therapeutic options for children with chronic disease. Home intravenous (IV) antibiotic treatment against Pseudomonas aeruginosa (PsA) in cystic fibrosis (CF) patients has offered increased flexibility to these patients and family life. A prospective clinical study was conducted to compare safety, efficacy, and cost benefits of home versus hospital IV antibiotic treatment among CF children and adolescents.
Method: The clinical outcome, quality of life, and cost benefits of home versus hospital antibiotic treatment were assessed. The clinical outcome was evaluated with Forced Expiratory Volume in one second (FEV1) and weight gain before and one month after antibiotic treatment, while the Quality of life was evaluated using the DISABKIDS questionnaire. Cost analysis was performed to calculate cost benefits from home IV treatment.
Results: Thirty-five stable patients with CF (mean age: 12.6 ± 7 years, 56 % male, mean FEV1: 83.5 ± 26 %), colonized with PsA, were treated with IV antibiotics for two weeks either in the hospital (15 patients), or at home (20 patients) under supervision by a home care nurse. Lung function (FEV1) and weight improved significantly in both groups (ΔFEV1% =7.7 ± 6.1, p <0.001; ΔWeight =1.2 ± 0.8, p <0.001). Hospital treatment did not show a better clinical outcome, compared to home treatment (ΔFEV1, p =0.606; ΔWeight, p =0.608). Both improvements in the quality of life and economical savings were substantial (p <0.001) regarding patients treated at home. Also, patients treated at home did not report any significant side effects or complications.
Conclusions: Home IV antibiotic therapy monitored by a home care nurse, is a safe, efficient, and cost-saving therapeutic option in CF. Hippokratia 2016, 20(4): 279-283.
Keywords: Cystic Fibrosis; Pseudomonas aeruginosa; antibiotic therapy; homecare; intravenous; quality of life.