Letter: Comment on outpatient intravenous therapy.

There has been a recent trend to treating more and more pediatric 
patients with chronic diseases on an ambulatory basis. This is true 
of both hemophilia and cystic fibrosis. Despite their success in keeping 
slightly more than two thirds of their patients out of the 
hospital, I think that they might be more successful in the 
future if the following points are considered. First, many of those 
initially selected for intravenous medications due to their nonresponsiveness to oral 
therapy and again later considered failures of intravenous treatment might actually 
be noncompliers. My second point concerns the lack of follow-up within 
the patient's home. It would seem to me that this would 
be an ideal place for a public health nurse to check 
on the patient's condition, ensure that the procedure was being properly 
followed under actual field conditions, and that the correct amount of 
medicine has been utilized. - Dr. David's letter regarding potential problems 
of noncompliance and home follow-up in the use of outpatient intravenous 
antibiotics points out the need for this type of therapy to 
be instituted only in those centers in which these facets can 
be well controlled. Public health nurses are utilized by some centers 
to supervise and assist in the home management of cystic fibrosis 
with good success. 