Out of hospital treatment of patients with melioidosis using ceftazidime in 24 h elastomeric infusors, via peripherally inserted central catheters

S Huffam, Susan Jacups, P Kittler, Bart Currie

Research output: Contribution to journalArticleResearchpeer-review

Abstract

BACKGROUND: In the tropical north of the Northern Territory, Australia, 25-50 patients are admitted to Royal Darwin Hospital (RDH) each year with Burkholderia pseudomallei infection, or melioidosis. Treatment consists of initial intensive therapy with 2-4 weeks of intravenous antibiotics. Clinical improvement may occur early and patients often prefer to be managed out of hospital in the Hospital in the Home (HITH). OBJECTIVES: To evaluate safety and efficacy of HITH management of patients with melioidosis. METHODS: A prospective observational study of our standard management which consists of 24 h infusions of ceftazidime infused through a peripherally inserted central catheter (PICC) line, plus oral sulphamethoxazole trimethoprim. Treatment is administered in the home, which may be in Darwin, regional areas or remote communities, or in a self-care unit located in the hospital grounds. RESULTS: From February 1998 to December 2001 150 patients were admitted to RDH with culture confirmed B. pseudomallei infection. Of these, 73 patients were treated with 24 h infusions of ceftazidime, of which 70 patients were managed by HITH. Complications of treatment include a PICC line complication rate of 10.6/1000 days in situ. Nine patients had relapse or recrudescence of disease, nearly all as a result of poor adherence to subsequent oral eradication therapy, these patients were all re-treated successfully. One patient remains infected with B. pseudomallei. CONCLUSION: This clinical outcome study suggests that out of hospital management of melioidosis with 24 h infusions of ceftazidime via a PICC line is safe and effective.
Original languageEnglish
Pages (from-to)715-717
Number of pages3
JournalTropical Medicine and International Health
Volume9
Issue number6
Publication statusPublished - 2004

Fingerprint

Melioidosis
Infusion Pumps
Ceftazidime
Catheters
Burkholderia pseudomallei
Burkholderia Infections
Therapeutics
Self-Care Units
Northern Territory
elastomeric
Sulfamethoxazole
Recurrence
Trimethoprim
Observational Studies
Outcome Assessment (Health Care)
Prospective Studies
Anti-Bacterial Agents
Safety

Cite this

@article{6182ca5fceda4dfba4ebbde78cde3932,
title = "Out of hospital treatment of patients with melioidosis using ceftazidime in 24 h elastomeric infusors, via peripherally inserted central catheters",
abstract = "BACKGROUND: In the tropical north of the Northern Territory, Australia, 25-50 patients are admitted to Royal Darwin Hospital (RDH) each year with Burkholderia pseudomallei infection, or melioidosis. Treatment consists of initial intensive therapy with 2-4 weeks of intravenous antibiotics. Clinical improvement may occur early and patients often prefer to be managed out of hospital in the Hospital in the Home (HITH). OBJECTIVES: To evaluate safety and efficacy of HITH management of patients with melioidosis. METHODS: A prospective observational study of our standard management which consists of 24 h infusions of ceftazidime infused through a peripherally inserted central catheter (PICC) line, plus oral sulphamethoxazole trimethoprim. Treatment is administered in the home, which may be in Darwin, regional areas or remote communities, or in a self-care unit located in the hospital grounds. RESULTS: From February 1998 to December 2001 150 patients were admitted to RDH with culture confirmed B. pseudomallei infection. Of these, 73 patients were treated with 24 h infusions of ceftazidime, of which 70 patients were managed by HITH. Complications of treatment include a PICC line complication rate of 10.6/1000 days in situ. Nine patients had relapse or recrudescence of disease, nearly all as a result of poor adherence to subsequent oral eradication therapy, these patients were all re-treated successfully. One patient remains infected with B. pseudomallei. CONCLUSION: This clinical outcome study suggests that out of hospital management of melioidosis with 24 h infusions of ceftazidime via a PICC line is safe and effective.",
keywords = "ceftazidime, cotrimoxazole, health care, adult, aged, article, bacterium culture, Burkholderia pseudomallei, catheter, child, clinical observation, clinical trial, community, controlled clinical trial, controlled study, drug delivery system, drug efficacy, drug infusion, drug safety, drug screening, eradication therapy, female, health care management, home care, hospital, hospital admission, hospital patient, human, major clinical study, male, melioidosis, outcomes research, prospective study, relapse, self care, standard, time, Adolescent, Adult, Aged, Anti-Bacterial Agents, Catheterization, Central Venous, Ceftazidime, Child, Child, Preschool, Equipment Failure, Female, Home Infusion Therapy, Humans, Infusions, Parenteral, Male, Melioidosis, Middle Aged, Northern Territory, Patient Compliance, Prospective Studies, Recurrence, Treatment Outcome, Bacteria (microorganisms), Burkholderia, Negibacteria",
author = "S Huffam and Susan Jacups and P Kittler and Bart Currie",
year = "2004",
language = "English",
volume = "9",
pages = "715--717",
journal = "Tropical Medicine and International Health",
issn = "1360-2276",
publisher = "Wiley-Blackwell",
number = "6",

}

Out of hospital treatment of patients with melioidosis using ceftazidime in 24 h elastomeric infusors, via peripherally inserted central catheters. / Huffam, S; Jacups, Susan; Kittler, P; Currie, Bart.

In: Tropical Medicine and International Health, Vol. 9, No. 6, 2004, p. 715-717.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Out of hospital treatment of patients with melioidosis using ceftazidime in 24 h elastomeric infusors, via peripherally inserted central catheters

AU - Huffam, S

AU - Jacups, Susan

AU - Kittler, P

AU - Currie, Bart

PY - 2004

Y1 - 2004

N2 - BACKGROUND: In the tropical north of the Northern Territory, Australia, 25-50 patients are admitted to Royal Darwin Hospital (RDH) each year with Burkholderia pseudomallei infection, or melioidosis. Treatment consists of initial intensive therapy with 2-4 weeks of intravenous antibiotics. Clinical improvement may occur early and patients often prefer to be managed out of hospital in the Hospital in the Home (HITH). OBJECTIVES: To evaluate safety and efficacy of HITH management of patients with melioidosis. METHODS: A prospective observational study of our standard management which consists of 24 h infusions of ceftazidime infused through a peripherally inserted central catheter (PICC) line, plus oral sulphamethoxazole trimethoprim. Treatment is administered in the home, which may be in Darwin, regional areas or remote communities, or in a self-care unit located in the hospital grounds. RESULTS: From February 1998 to December 2001 150 patients were admitted to RDH with culture confirmed B. pseudomallei infection. Of these, 73 patients were treated with 24 h infusions of ceftazidime, of which 70 patients were managed by HITH. Complications of treatment include a PICC line complication rate of 10.6/1000 days in situ. Nine patients had relapse or recrudescence of disease, nearly all as a result of poor adherence to subsequent oral eradication therapy, these patients were all re-treated successfully. One patient remains infected with B. pseudomallei. CONCLUSION: This clinical outcome study suggests that out of hospital management of melioidosis with 24 h infusions of ceftazidime via a PICC line is safe and effective.

AB - BACKGROUND: In the tropical north of the Northern Territory, Australia, 25-50 patients are admitted to Royal Darwin Hospital (RDH) each year with Burkholderia pseudomallei infection, or melioidosis. Treatment consists of initial intensive therapy with 2-4 weeks of intravenous antibiotics. Clinical improvement may occur early and patients often prefer to be managed out of hospital in the Hospital in the Home (HITH). OBJECTIVES: To evaluate safety and efficacy of HITH management of patients with melioidosis. METHODS: A prospective observational study of our standard management which consists of 24 h infusions of ceftazidime infused through a peripherally inserted central catheter (PICC) line, plus oral sulphamethoxazole trimethoprim. Treatment is administered in the home, which may be in Darwin, regional areas or remote communities, or in a self-care unit located in the hospital grounds. RESULTS: From February 1998 to December 2001 150 patients were admitted to RDH with culture confirmed B. pseudomallei infection. Of these, 73 patients were treated with 24 h infusions of ceftazidime, of which 70 patients were managed by HITH. Complications of treatment include a PICC line complication rate of 10.6/1000 days in situ. Nine patients had relapse or recrudescence of disease, nearly all as a result of poor adherence to subsequent oral eradication therapy, these patients were all re-treated successfully. One patient remains infected with B. pseudomallei. CONCLUSION: This clinical outcome study suggests that out of hospital management of melioidosis with 24 h infusions of ceftazidime via a PICC line is safe and effective.

KW - ceftazidime

KW - cotrimoxazole

KW - health care

KW - adult

KW - aged

KW - article

KW - bacterium culture

KW - Burkholderia pseudomallei

KW - catheter

KW - child

KW - clinical observation

KW - clinical trial

KW - community

KW - controlled clinical trial

KW - controlled study

KW - drug delivery system

KW - drug efficacy

KW - drug infusion

KW - drug safety

KW - drug screening

KW - eradication therapy

KW - female

KW - health care management

KW - home care

KW - hospital

KW - hospital admission

KW - hospital patient

KW - human

KW - major clinical study

KW - male

KW - melioidosis

KW - outcomes research

KW - prospective study

KW - relapse

KW - self care

KW - standard

KW - time

KW - Adolescent

KW - Adult

KW - Aged

KW - Anti-Bacterial Agents

KW - Catheterization, Central Venous

KW - Ceftazidime

KW - Child

KW - Child, Preschool

KW - Equipment Failure

KW - Female

KW - Home Infusion Therapy

KW - Humans

KW - Infusions, Parenteral

KW - Male

KW - Melioidosis

KW - Middle Aged

KW - Northern Territory

KW - Patient Compliance

KW - Prospective Studies

KW - Recurrence

KW - Treatment Outcome

KW - Bacteria (microorganisms)

KW - Burkholderia

KW - Negibacteria

M3 - Article

VL - 9

SP - 715

EP - 717

JO - Tropical Medicine and International Health

JF - Tropical Medicine and International Health

SN - 1360-2276

IS - 6

ER -