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IMPLEMENTATION OF ELASTOMERIC INFUSION PUMPS FOR THE ADMINISTRATION OF ANTIMICROBIAL AGENTS IN COORDINATION WITH HOME HOSPITALIZATION

European Statement

Clinical Pharmacy Services

Author(s)

Eva Gómez-Costa; María Begoña Feal-Cortizas; María Mateos-Salvador; Sandra Rotea-Salvo; Andrea Luaces-Rodríguez; Laura Caeiro-Martínez; Clara Fernández-Diz; Andrés Torres-Pérez; Luis Margusino-Framiñán; María Isabel Martín-Herranz

Why was it done?

Implementation of a circuit for the preparation and dispensing of elastomeric infusion pumps (EIPs) prepared in a Hospital Pharmacy Service, designed for the continuous intravenous administration of antimicrobial agents in coordination with Home Hospitalization Units (HHU).

What was done?

The purpose of this initiative is to provide an effective and safe alternative for treating infections in patients who would otherwise require prolonged hospital stays. The use of EIPs improves patients’ quality of life and reduces treatment costs by decreasing hospital admissions.

How was it done?

The Pharmacy Service contributed to the development of this initiative by studying the stability of antimicrobial agents in the EIPs, determining dilution volumes based on the maximum possible concentration, and assessing storage conditions, among other factors. The appropriate EIP was selected for each antibiotic to ensure effective and safe infusion rates. EIPs are prepared in laminar flow hoods to maintain a sterile environment during medication preparation. Additionally, educational materials for healthcare professionals were developed, and training sessions were conducted for HHU staff.

What has been achieved?

In 2023, a total of 2,223 EIPs were prepared to treat 123 patients, resulting in a reduction of 1,426 hospital days. Compared to previous years, there was a 243% increase in the number of infusers and a 131% increase in the number of patients between 2017 and 2019. Between 2019 and 2023, there was an 11.9% increase in infusers and a 36.7% increase in patients.
The antimicrobials used were: meropenem (59.6%), piperacillin/tazobactam (19.9%), cefazolin (6.8%), ceftazidime (5.6%), ceftaroline (2.2%), penicillin G (2.1%), tobramycin (1.5%), ampicillin (0.7%), acyclovir (0.6%), ceftolozane/tazobactam (0.6%), and ceftriaxone (0.4%).

What next?

Future research is expected to expand on the efficacy and safety of this methodology by studying stability times at different concentrations of agents antimicrobials to establish a sustainable model that can benefit an increasing number of patients. Additionally, patient surveys will be conducted to gather insights into their experiences and enhance their quality of life.

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