Who to Refer

Who is suitable for community treatment with IV antibiotics?

The key inclusion criteria are that the patient really needs IV antibiotics and they are medically stable to be managed at home. In addition they must be adults, registered with a GP, with access to a telephone and have suitable IV access. A peripheral cannula is acceptable for courses of less than 9 days. A midline or PICC line is required for longer courses.

Aside from patients with cellulitis, we expect the need for IV antibiotics to be discussed with an infection specialist (ID or micro) and their name recorded on the referral form.

Admission avoidance

We receive many referrals from GPs and in the same way the Emergency departments can refer patients and avoid their unnecessary admission.

In our experience, the most suitable patients have cellulitis or urinary tract infections thought to be caused by multi-resistant bacteria (requiring the use of IV ertapenem).

Early support discharge

Any hospital patient on IV antibiotics who becomes medically stable can be considered for community care. For the majority of these patients, a switch to oral antibiotics is the most appropriate action. In some cases an Infection specialist (ID/micro) will recommend intravenous antibiotics in a stable patient and they should be referred promptly.

Who is not suitable for community treatment with IV antibiotics?

The referral form outlines the full inclusion and exclusion criteria. We should not be treating patients with sepsis or who cannot swallow as IV fluids cannot be safely given.

Most patients do not require more than 48 hours IV therapy and therefore we ask that the treatment plan is discussed with micro/ID – unless the patient has cellulitis.