Home intravenous antimicrobials

Some patients may be eligible for intravenous antimicrobial treatment at home through our CHQ at Home and Hospital in the Home (HITH) service.

Help and referrals

If you work for Children's Health Queensland, access the referral and eligibility information on the intranet. To refer your patient contact the CHQ at Home team.

CHQ at Home Registrar

• Page via QCH Switchboard: 07 3068 1111

CHQ at Home Nurse coordinator

• Phone: 0432 003 030

You'll also need approval from the infectious disease (ID) specialist or fellow for all home intravenous antimicrobial treatments. Call 07 3068 1111 to request approval. For help and advice with medicine suitability and dosing call us or the CHQ at Home pharmacist.

CHQ at Home pharmacist

• Phone: 0437 976 230

Antimicrobial stewardship pharmacist

• Phone: 0436 815 492

Approved HITH pathways are available for patients who:

• have cystic fibrosis [PDF 613.07 KB] and are receiving Tobramycin, Piperacillin-Tazobactam or Ceftazidime treatment
• have non-cystic fibrosis bronchiectasis [PDF 458.54 KB] and are receiving Ceftriaxone treatment
• are admitted by the oncology team with low risk febrile neutropenia (for Queensland Heath staff on the intranet) and are receiving 24 hour clinical reviews by an oncologist or infectious disease specialist.

Patients presenting to the emergency department are also eligible for the HITH pathway if they meet the meet the CHQ Hospital In the Home antibiotic guideline [PDF 443.46 KB] criteria for:

• community acquired pneumonia
• cellulitis
• lymphadenitis
• peri-orbital cellulitis
• urinary tract infections
• pyelonephritis.

Home IV antimicrobial prescribing guidelines

Before you prescribe an antimicrobial for home use consider the medicine's:

• safety and effectiveness
• appropriate intravenous access
• appropriate dosage
• medicine stability such as the temperature of the environment where it will be stored or used
• device for administration such as a springfusor, infusion bag with pump or elastomeric device.

If you work for Children's Health Queensland, read the following home antimicrobial and administration device guidelines on the intranet.

• CHQ at home outpatient parenteral antimicrobial therapy prescribing, administration and monitoring guideline
• Preparation of antibiotic infusion solutions for CHQ at Home
• Continuous IV infusion administration via ambit pumps for HITH
• Elastomeric infusor device infusion record
• Ceftazidime intermate device medicines fact sheet
• Allergic reaction emergency management in children
• Medication administration
• Central venous access device (CVAD): Patency, flushing and locking

Search parenteral antimicrobials and suitability for home use

Supportive medication orders required for patients receiving IV antimicrobials at home

Prescribe the following supporting medicines in addition to the parenteral antimicrobial orders in ieMR before you transfer your patient from inpatient to the HITH service.

Medicine	Dosage	Usage considerations
Sodium Chloride 0.9% flush	5-10 mL IV PRN	To flush IV access device pre and post medication administration Some medicines are not compatible with sodium chloride 0.9 % and may require glucose 5 % as an IV flush
Long term heparin lock	Dilute 1 mL of 1000 units/mL Heparin with 9 mL Sodium Chloride 0.9%. Final concentration of 100 units/mL heparin. Use 1 to 2 mL IV PRN as along term heparin lock (volume is dependent on type of device)	Use for more than 24 hours Not to be used for haemophilia patients
Cetirizine (Zyrtec)	1 to 2 years of age 0.25 mg/kg/dose (up to 2.5 mg/dose), twice daily PO 2 to 5 years of age 5 mg, daily PO (can divide into 2 doses) 6 to 12 years of age 10 mg, daily PO (can divide into 2 doses)	Chart as PRN order Use in the event of allergic reaction
Adrenaline (Epipen)	If less than 20 kg: Give 150 microgram as intramuscular injection If more than 20 kg: Give 300 microgram as intramuscular injection	Chart as a once only PRN order Intramuscular injection Use in the event of anaphylaxis Quantify indications for administration under order

External resources

• Australian therapeutic guidelines for HITH on the Therapeutic Guidelines website
• Elastomeric products’ professional guide on the Baxter website
• Patient guide – infusor on the Baxter website