Teicoplanin in home therapy of the terminally ill child

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Abstract
Abstract:  Children discharged in the terminal phase of illness were offered the possibility of having central venous line infections treated with teicoplanin at home by their parents after suitable instruction. The decision to begin antibiotic treatment was subjective, based on a history of rigors and/or raised temperature in an otherwise “well” child. No difficulties were encountered in instructing the chosen parents. In all, five treatment periods of 7 days were required in the five children selected. The review time was 31 weeks (mean duration, 6.2 weeks/patient; range, 4–12 weeks), ended in all cases by death. Infection occurred a mean of 3.2 weeks after discharge (range, 1–8 weeks), and all episodes were successfully treated at home without hospital admission or ward‐based support. No deaths occurred as a result of antibiotic therapy failure, and there were no clinically relevant side‐effects. Autopsy confirmed the absence of central venous line infection in one patient, but blood culture was positive for Staphylococcus aureus in another. This study shows that home treatment of line infections with teicoplanin is effective and well tolerated, and offers advantages in terms of quality of life and parent‐child relationships.