IV antibiotics find new home
Treating children with antibiotics through an intravenous drip at home appears to be just as effective and safe as hospital treatment and is better for quality of life.
A new study led by the Murdoch Children’s Research Institute has found treatment for the bacterial skin condition cellulitis in children should be done at home or in outpatient care where possible.
Lead author Dr Laila Ibrahim said having intravenous antibiotics therapy at home is becoming increasingly common but there was no evidence of its benefits from clinical trials until now.
This is the first trial worldwide in children that has compared IV antibiotic treatment at home to hospital.
“Home treatment for childhood infections is just as good as hospital care,” Dr Ibrahim said.
She ran a trial involving 188 children, aged 6 months to 18 years, who presented to the emergency department at The Royal Children’s Hospital Melbourne with moderate to severe cellulitis.
Participants were randomly assigned either intravenous ceftriaxone at home with a nurse and doctor visiting the home or intravenous flucloxacillin at hospital.
Dr Ibrahim said 95 per cent of parents reported high satisfaction rates of having their child treated at home, much higher than in hospital.
“Being in hospital negatively impacts a child’s mental and emotional health and disrupts family routine,” she said.
“We keep admitting children to hospital because there have been no good studies showing that treatment at home is as good as hospital treatment.”
Treatment failure occurred in 2 per cent of children in the home group and in 7 per cent of children in the hospital group. Adverse reactions such as diarrhea and vomiting happened less frequently at home and there was no difference in complication rates which were very low.
Repeat insertions of IV cannulas or drips was 3 per cent in the home whereas it was 18 per cent for children in hospital.
Dr Ibrahim said treatment in the home also has cost-saving benefits.
The cost of treating a patient with cellulitis at home is $530 per day compared to $1297 per day at hospital. It cost over $100,000 more in total to care for the 95 children in hospital during the study than the 93 at home.