Eighty-nine pediatric patients (median age, 12.0; range, 1.5 to 18 years) were treated with antibiotics given intravenously by self- or parent administration for a variety of infections, under close physician supervision. Patients with infections involving bone and joint (53), respiratory tract (16), soft tissue (9), abdominal cavity (4), genitourinary tract (4) and bloodstream (3) were treated for a mean period of 19.0 days. Staphylococcus aureus, Pseudomonas aeruginosa and Haemophilus influenzae were the most frequent pathogens. Favorable clinical outcomes occurred in 85 patients (96%). Adverse clinical and laboratory events occurred at a frequency commensurate with that of hospitalized patients. A total of 1700 patient days were managed in this outpatient setting at significant cost savings, and the method allowed early return to school for 83 patients (93%). Intravenous antibiotic therapy in ambulatory patients can provide a successful, safe, cost-effective alternative to inpatient care under conditions of diligent patient screening and physician-centered follow-up.
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