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Thread: resistent bacteria cont - seeking your experiences with iv meds on outpatient basis

  1. #1

    resistent bacteria cont - seeking your experiences with iv meds on outpatient basis

    yes I'm still dealing with this 8 months now and it's finally beaten me. I did get rid of the foam by diligently cathing every 4-5 hours and drinking 2.5 liters of water a day for a month but overslept a few too many times recently and some bubbles are coming back. Plus I still have dizziness and worst of all the bladder spasms.

    btw I realized what must have made me symptomatic, after my mitro revision my doc put me on 2 days of preventative IV anti-biotics [followed by 3 weeks on a foley of course] which I guess is why all the oral anti-biotics didn't subsequently treat the uti.

    so I want to know about the logistics of doing iv antis on a outpatient basis which I'm sure I've read some of you guys have done as I'm going to beg my doc to give them to me. I live 15 miles from a hospital but it would be nice if someone also comes to my house, that's got to be cheaper than hospitalization. how long a course do you do with iv antis is it just as long or does it depend on the med? thanks I want to be prepared.
    Last edited by leschinsky; 01-31-2010 at 08:04 PM.
    Embrace uncertainty. Hard problems rarely have easy solutions. Jonah Lehrer

  2. #2
    Lesch, I am so sorry this is still dragging on with you! I can't imagine your frustration with battling this.

    The home health care treatment model is the only way to go. Your doctor should be able to order it for you. He/she will determine what meds you need and write the orders, then fax them over to the agency serving your area. Depending on the agency, they may provide the drugs or you may need to take a script to pharmacy and fill it yourself. After that, the agency contacts you, a nurse comes out and administers your meds, and you never need leave your house. The best part -- if you have Medicare, this is covered at 100 percent. I paid nothing except the cost of the antibiotics for two plus weeks of daily visits.

    As far as what treatment was like, I was lucky in that my strain of pseudomonas was sensitive to Ceftriaxone (Rocephin). It can be given through IM injection, so I didn't need to deal with a PICC line or IVs -- just one gram per shot per day in a large muscle for 14 days in a row. Ask your doc if Rocephin or another injectable drug is on your C&S -- it's a lot less hassle if you can go IM.

    One thing about home health care -- you cannot go to any PT/OT, etc. outside of your home while receiving home care services or Medicare will determine you are no longer home bound and eligible for home care.

    Hope this works out for you, both by avoiding an in-patient stay and kicking this infection's ass once and for all.
    Last edited by thehipcrip; 01-28-2010 at 02:16 AM.
    It is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience.

    ~Julius Caesar


  3. #3
    Just curious, what are the foams that you mentioned in your post?

  4. #4
    A lot will depend on the specific antibiotic you need to take, how often, and what your insurance will cover. In addition, what home health services are available in your area make a big difference. Sometimes you can be trained to administer the drug (or a caregiver), some may need to be given by a nurse, or with a pump that can be pre-programmed (and not every area has these, nor do all insurances cover them). In addition, you would need to have a way to get the pre-mixed antibiotic solution, which must be done in a special clean room with a hood (it is not safe to reconstitute these drugs in a home setting). Some cannot be made more than a few hours ahead of time, and many require refrigeration.

    You should certainly explore your options, and what your insurance will cover with your physician and local home health agencies as well. I assume you already have the PICC or central line in place?

    (KLD)

  5. #5
    I was on home IV antibiotics (oxacillin, I believe) for 4 weeks after spine revision surgery with infected spinal hardware. I did this through the Infectious Disease doctor's office who had a nurse start a PIC line in my arm (it is threaded into a larger vessel - SVC) and was given a fanny pack that I wore that had the pump in it. I had to go back to their office for a refill every other day. I think it depends on the stability of the drug in liquid as to how often it has to be mixed and replaced.
    I hope this helps.

  6. #6
    Hi Lesch, this was my last day for iv therapy. I started while in the hospital, they found one bacteria and then a second. That was the reason for the second and third surgeries. I think I've been on a total of four different kinds, they changed them after finding the second bacteria.

    The doctor had his staff at his clinic check to see the cheapest and best way for my to take the iv's and it ended up being cheaper for me to go to the clinic fifty some miles away.

    My last med was cubicin, it's an unstable drug and has to be kept cold, so the last two weeks I did'nt use the personal size pump at all, I had to go to the clinic every day. I noticed the eight weeks of going there are many kinds of antibiotics, some people were shown how to do it themselves twice a day at home and only came in for their blood work to be done, bandage changed around the picc line, and to pick up more meds.

    Depending on the infection, you could be in therapy for a few weeks, or longer. My numbers did'nt come down as much as they wanted (things like sed rate), but could be affected by other things. I just hope it worked.

    Good luck Lesch.

  7. #7
    Quote Originally Posted by SCI-Nurse View Post
    A lot will depend on the specific antibiotic you need to take, how often, and what your insurance will cover. In addition, what home health services are available in your area make a big difference. Sometimes you can be trained to administer the drug (or a caregiver), some may need to be given by a nurse, or with a pump that can be pre-programmed (and not every area has these, nor do all insurances cover them). In addition, you would need to have a way to get the pre-mixed antibiotic solution, which must be done in a special clean room with a hood (it is not safe to reconstitute these drugs in a home setting). Some cannot be made more than a few hours ahead of time, and many require refrigeration.

    You should certainly explore your options, and what your insurance will cover with your physician and local home health agencies as well. I assume you already have the PICC or central line in place?

    (KLD)
    No not yet I wanted to get some info before I call my doctor. i think I'll run by you guys what he recommends because I want to make sure he does whatever drug for the right amount of time. I have a really stupid question for you K. I've been drinking mostly hot water because it's been a cold winter, that doesn't make a difference to the bacteria in my bladder does it?

    Thanks for relating your experiences all smoky I hope that works for you sounds rough. Hip once a day injection would be great I could drive to the hospital daily, I hope one is sensitive to it. Unfortunately I have blue cross with a $1500. deductable and a 30% insurance and I haven't paid off my botox coinsurance payment yet [trying to negotiate with stanford as $2400.+ is ridiculous] so I need to do this the cheapest way possible.

    Weimen I've had bubbly urine which is a sign of a bad uti. weird thing is I dont develop a fever.
    Embrace uncertainty. Hard problems rarely have easy solutions. Jonah Lehrer

  8. #8
    Hi Lesch, thanks for the reply! hope you are feeling better already!

  9. #9
    Hi, I had Ertapanem IV for 15 days a couple of years ago, for an infection that was resistant to everything that could be taken orally. It did the trick. The infection had been there before for 4 months more or less, I think, and never got properly treated. Most GPs dont know much about how to treat complicated UTI's, so eventually, it had to get so bad that I had to go to Hospital and see a proper infectious disease dr.

    I guess the most important thing is for the Dr to be sure that whatever she prescribes is the right drug. I drove to the hospital everyday, and had an IV installed. It took aproximately 2 hours each time, plus the driving, but it was certainly better than being an in-patient. I had shunt in my hand or arm all the time, which was a pain (literally) when sleeping or showering, but completely torelable.

    Hope the IV antibiotic takes care of your infection. Hang in there!

  10. #10
    I hope the therapy has worked too. Yesterday was my last day for the iv and I've switched to an oral that will only work on one of the bacterias.

    I wish you much luck and hope you can get rid of the infection. You'll feel much better and it will be good to get you off meds that are'nt working. I have BCBS too, it's a medicare plan and after the busy year I've had in 2009, I'm glad I choose one of the best ones they offered. In the eight weeks of therapy, I ended up $403 out of pocket.

    Keep us posted Lesch and take care. T~

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