Abstract
Introduction: Children with bronchiectasis have recurrent exacerbations and many require hospitalisation. ‘Hospital in the home (HITH)’ is an alternative to hospitalisation for children with Cystic-Fibrosis(CF) but there is little data in those without CF. We describe our experience of HITH in a cohort of children with bronchiectasis and compared outcomes between hospital- and HITH-based pathways.
Methods: Medical records were retrospectively reviewed in children with bronchiectasis who were hospitalised in our centre from Jan-2017 to June-2018. We assessed treatment duration, symptom resolution, oral antibiotic prescription on discharge, adverse events and time to next exacerbation.
Results: We analysed 54 exacerbations (HITH n=38, 70%) in 46 children [median age=4.5 (IQR 2-10.25) years; females=26, Indigenous=6]. Mean (SD) IV antibiotic therapy was for 14.9 (2.7) days. There was no difference in duration of treatment between the HITH [median=14 (IQR 14-16.25) days] vs. hospital groups [14 (14-14); p=0.65]. 21/38 (55.2%) children in the HITH group had symptom resolution at end of IV treatment compared to 10/16 (62.5%) in the hospital group; p=0.62 with 26% children in the HITH group discharged on oral antibiotics compared to 47% of the hospital group; p=0.13. There was no difference in time to next exacerbation between groups [HITH median=12 (7-15.75) weeks, hospital=9(6-24)]. No difference in adverse events was seen between the two groups.
Conclusions: A high proportion of pulmonary exacerbations in children with bronchiectasis requiring IV antibiotics are managed with HITH. The equivalence of HITH to inpatient treatment remains conjectural until prospective studies are undertaken.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA5001.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019