IV Antibiotics: Hospital or Home?

A big box was dropped on my doorstep filled with the most unexciting gifts: IV antibiotics. After a small bout of hemoptysis at the end of my pregnancy, my CF team and I decided it was a good idea to start IV antibiotics to give me a boost.

Ultimately, my team knows I avoid the hospital like the plague (not an intended pun considering everything going on) and prefer to do IVs from the comfort of my home with the help of a home care nurse to draw labs and monitor symptoms.

Everyone with CF has their preference when it comes to IVs and where they prefer to get treatment. Some people prefer to be admitted to the hospital while others prefer to stay home. Although it’s dependent on the person, each situation has their own accompanying list of pros and cons.

In what situations is best to do in-patient IVs at the hospital versus a course of IVs at home? Let’s find out!

What are IV antibiotics used for in CF?

Cystic fibrosis causes frequent and recurrent lung infections due to thick and sticky mucus trapping bacteria in the lungs.¹ When the infections are exacerbated and can’t be treated with oral and inhaled antibiotics, intravenous antibiotics may be prescribed and administered through a peripheral IV, PICC line, or port.

IV antibiotics are a common form of treatment to improve respiratory symptoms, lung function, and fatigue. Typically IV antibiotics are given for a minimum of two weeks and longer until symptoms resolve or the person is back to baseline.

Hospital admission

For a long time, the only place a course of IV antibiotics could be given was in the setting of the hospital. That meant the person would get admitted to the hospital, get a peripheral IV, PICC line or portacath placed and stay the length of the treatment, sometimes 2 weeks or more. Lengthy hospital stays are not easy, physically and mentally, but there are some pros and cons that come with an in-patient stay.

Pros of in-patient stay:

• Around the clock help from medical staff
• Rest from normal activities
• No cleaning or cooking
• Access to different speedy medication changes and testing

Cons of in-patient stay:

• Disrupted sleep
• Time away from friends and family
• Isolation and loneliness
• Risk of germs
• Hospital food

Home IVs

Thanks to the advancement of treatment and monitoring, a course of IV antibiotics can now be done completely at home. In my case, I access my port and wait for a delivery of antibiotics from Homecare and begin treatment as easy as that. The medications come in a mobile and compact self-collapsing ball that infuse without an IV pole. It’s incredibly less stressful and disruptive to my busy mom-life in comparison to an in-patient stay. However, being at home while on IVs can get me into trouble when I don’t take the time to rest and ask for help.

Pros of home IVs:

• Sleeping in own bed
• Can resume work, school, and normal activities
• Surrounded by family and friends
• Home cooked meals
• Freedom to make own medication schedule

Cons of home IVs:

• Disrupted sleep
• Treatment burden falls on patient and family
• Hard to rest completely
• Can be mentally exhausting

Some questions to consider in your decision

Immediately when my CF Care Team and I decide it’s time for IVs, I always jump to the conclusion that I will do home IVs. However, I know from experience as a stay-at-home-work-from-home-mom that that’s not always the best setting to get better. Instead, I need to take a step back and evaluate each course of IVs independently and pick the most beneficial option. To do so I ask myself some questions:

• Will my body have more opportunity to heal at home or in the hospital?
• Do I have the energy to care for myself or do I need outside help?
• Am I stable enough to be at home?
• What can I get off my plate at the moment to make this easier?
• Is it cold or flu season?
• How is my mental health at the moment?

Depending on the answers to these questions, as a family with the guidance from my CF Care Team we put a plan in place to get me feeling better and back to baseline.

How do you decide where to do IVs? Do you prefer the hospital or home setting? Share your thoughts below!