• A K F Htin, N D Friedman, A Hughes, D P O'Brien, S Huffam, A-M Redden, and E Athan.
• Barwon Health, Geelong, Australia. anthonykwanfu.htin@gmail.com
• Intern Med J. 2013 Jun 1; 43 (6): 700-5.

BackgroundOutpatient parenteral antibiotic therapy has been shown to be efficacious, safe and cost-effective for a variety of infections. The data from managing infective endocarditis (IE) with hospital in the home (HITH) are limited. We evaluated the safety and outcomes of patients with IE treated with HITH at our centre.AimsTo evaluate the safety, efficacy and 1-year outcomes of patients with IE treated under HITH at our centre over 9 years.MethodA retrospective analysis of the clinical outcomes of all cases of IE treated with HITH at a tertiary referral centre was undertaken for patients treated between June 2002 and July 2011 (9 years). Outcome measures included clinical cure, readmission rate, relapses and 1-year mortality.ResultsSixty-eight cases of IE were treated with HITH over the study period, including 29 native valve infections, 24 prosthetic valve infections, 12 pacemaker lead infections, 1 defibrillator lead infection, 1 myocardial wall infection and 1 aortic graft infection. Thirteen cases had valve replacement surgery and 12 cases had removal of infected pacemaker leads. Staphylococcus aureus (18 cases), Coagulase-negative staphylococcus (10 cases) and viridians-group streptococcus (18 cases) were the most common pathogens. Median duration of antimicrobial therapy with HITH was 24 days (range 4 to 42 days). There were three readmissions during antimicrobial therapy with HITH. Two patients relapsed. There were two deaths and one patient was lost to follow up. One-year survival was 96% (65/68).ConclusionOutpatient antimicrobial therapy with HITH is safe and effective in carefully selected cases of IE.© 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

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