In this report, we describe incremental changes, during a 2-year period at a single center with the administration of maintenance infliximab infusions. Given practice-driven changes consisting of 1-hour infusions and omission of premedications, we aimed to investigate if these changes contributed to severe infusion reactions. We reviewed approximately 900 infliximab infusions in a pediatric ambulatory infusion center from January 1, 2014, to December 31, 2015, for severe adverse reactions requiring either rescue epinephrine or a code blue or “rapid response” activation. In 2015, these practice changes resulted in a 51% decrease in total infusion hours (1281 to 630 infusion hours), despite a 9% increase in total number of infusions. No increase in severe adverse events associated with either rapid 1-hour infusion or omission of premedications. Our findings highlight a quality-improvement opportunity to standardize infliximab infusions to streamline care in an ambulatory setting.
*Department of Pharmacy, Lucile Packard Children's Hospital, Stanford
†Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA.
Address correspondence and reprint requests to K.T. Park, MD, MS, Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA 94304 (e-mail: email@example.com).
Received 28 October, 2016
Accepted 23 January, 2017
K.T.P. is supported by National Institutes of Health (DK094868) for this research.
K.T.P. also received research support from AbbVie, Janssen, and Takeda, but not directly pertaining to this research.
The authors report no conflicts of interest.