Intravenous antibiotics are antibiotics delivered into a vein by injection or through a catheter.
Antibiotics are medicines that are used to treat or prevent bacterial infections. Antibiotics can be given by the following routes:
orally (by mouth) – tablets, capsule, liquid
topically (on your skin) – cream, ointment
by injection.
Your healthcare team will work out which route is the best for you. They will consider how severe your infection is and what types of bacteria are causing the infection.
When are antibiotic injections given?
Antibiotic injections may be given when:
your infection is severe and other routes may not work as well
you can't take oral antibiotics, for example because of being sick (vomiting)
the antibiotic treatment for the bacteria that is causing your infection can only be given by injection.
Injections can be given in different ways. The most common are into the vein (intravenous), muscle (intramuscular) or fatty tissue (subcutaneous). They are usually administered in hospital but can be administered at home. Read more about intravenous antibiotics at home.
How are intravenous (IV) antibiotics given?
The most common ways of giving an intravenous antibiotic are below.
Intravenous injection An intravenous injection is an injection given over a few seconds or a few minutes. Intravenous injection is sometime called a bolus injection.
Intermittent infusion An intermittent infusion is an injection given over 15 minutes or a few hours.
Continuous infusion A continuous infusion is an injection given over 24 hours.
PICC line Intravenous antibiotics can be given through a peripherally inserted central catheter known as a PICC line. This route is often used for patients needing intravenous antibiotics at home. Read more about PICC lines.
How long are intravenous (IV) antibiotics given for?
Your healthcare team will let you know how long you need to be on IV antibiotics. It will depend on how your infection is healing.
Credits: Health Navigator Editorial Team. Reviewed By: Sera Rahadi, Senior Clinical Pharmacist, Auckland City Hospital
Last reviewed: 11 Feb 2022
What is the home IV antibiotic service?
In hospital, you may have been started on intravenous (IV) antibiotics to treat an infection. You may be well enough to go home before your course of IV antibiotics is finished. Many hospitals offer an intravenous antibiotics at home service which lets you finish your antibiotic treatment safely at home.
Each hospital may have a different name for the home IV antibiotics service. This may be OPIVA (outpatient IV antibiotic), OPAT (outpatient antibiotic therapy) or HITH (hospital in the home).
The home IV antibiotic service is made up of infectious disease doctors, specialist nurses and pharmacists. In the community, there are district nurses who can help with the service.
How will I know if I can have the home IV antibiotic service?
If you are well enough to go home but need further IV treatment, a nurse from the home IV antibiotic service will meet with you in hospital to decide if you are suitable for the service. The process will be fully explained to you.
If you join the service, arrangements will be made to make sure you are able to go home safely. The team will talk to you about the following:
How you will get your supply of antibiotics and equipment.
How your doses will be given.
How to deal with problems such as blocked lines and missed doses.
Who to contact if you need any help.
How to look after your intravenous line.
What to do at the end of your treatment.
What are the benefits of the service?
You will be able to be at home in a comfortable and familiar setting rather than staying in the hospital. Feedback from previous patients has shown that they would choose it again rather than having a longer hospital stay. It allows you to maintain your independence, be back with your whānau and friends and even return to work.
How are IV antibiotics given at home?
Most patients who go home on IV antibiotics have a peripherally inserted central catheter (PICC), also called a PICC line put in. Read more about PICC lines.
Your PICC line will then be used to deliver antibiotics. The most common way of having your antibiotics is from an infusor. These are a lightweight, single-use, disposable device which is used to deliver medicines (like IV antibiotics) slowly over a certain time period. Inside the infusor is a balloon that holds your IV antibiotics. The image below shows how your infusor bottle will look before you start your dose. As the dose is delivered, the balloon holding your antibiotic becomes empty and shrinks. It is important to know that:
The bottles are stored in the fridge until you are ready to use them. Let your nurse know if you do not have a fridge at home.
The infusor will be connected to your PICC line. It will be placed in a small waist bag (bum bag) so you can comfortably move around.
At the end of the 24 hours, a new infusor is connected.
The balloon can empty before your next dose is due - this is normal and nothing to worry about.
Image credits: Infusor (Baxter, AUS)
Who will give me the IV antibiotics and care for my line?
The service is set up for what you need. Most community teams provide nurses who can visit you in your home and administer your antibiotic. Some people choose to give themselves the antibiotic, or a whānau member/friend will take on this role. If this is the case then you or your family member/friend will be taught how to do this and will be assessed in hospital by the team.
Who will check that everything is going ok?
You will start your antibiotics in hospital. This way your healthcare team can monitor your initial response to the treatment and check if you have any side effects like allergic reactions.
Occasionally your IV line can become blocked or an infection can develop. If there are any problems then contact your healthcare team (you will be provided with contact information by the home IV antibiotic team) and you will be quickly assessed and if necessary, readmitted back into hospital.
When you are at home with IV antibiotics, you will need to have regular blood tests (usually once a week). You may need to have regular clinic appointments during your treatment. This is so the home IV antibiotic team can see if your infection is improving and can check how you are getting on at home.
What happens when my IV antibiotic treatment is finished?
Once the home IV antibiotic team are happy that your infection has gone, you can be discharged from the service. If that is the end of your treatment, the team will arrange to remove any administration lines.
Who to contact if you need help
The home IV antibiotic team will give you a list of people you can contact if you have any questions or concerns while part of the service.
A peripherally inserted central catheter (PICC), also called a PICC line, is a long, thin line through which medicines or liquid nutrition can be delivered to your body. PICC lines are sometimes called central lines or CVAD (central venous access devices).
The PICC line is inserted through a vein in your arm and passed through to the larger veins near your heart. This procedure is done in hospital and you will be given an anaesthetic so you won't feel the procedure. You may have some mild discomfort for a few days after.
Sometimes the line is divided into 2 or 3 lines. This allows you to have different treatments at the same time.
Image credits: PICC line (Macmillan, UK)
What is a PICC line used for?
A PICC line can be used to give you treatments such as:
chemotherapy
blood transfusions
antibiotics
intravenous (IV) fluids
liquid food if you are not able to eat.
It can also be used to take samples of your blood for testing.
You can go home with the PICC line in. It can be left in for weeks or months. If you need long term treatment, the line can stay in for up to a year.
How is a PICC line put in?
A PICC line can only be put in by a specialist nurse or doctor in hospital. Before the line is put in, an anaesthetic injection will be given to numb the area. The whole procedure is painless. Your health care team will use ultrasound scans to help them find the safest place to put the line in. The ultrasound uses sound-waves to produce a picture of the veins in your arm. You will then have a chest x-ray to check that the end of the tube is in the right place.
This animated video shows you how a PICC line is put in.
How to look after your PICC line
In general, PICC lines don’t need a lot of care, but it’s important to keep your PICC line dressing clean and dry. You should cover the dressing with a waterproof dressing when you shower. Avoid activities where the line would be submerged in water, eg, swimming or bathing. Your district nurse will change your waterproof dressing regularly.
Important things to look out for
Contact your nurse or doctor urgently if you notice any of the following.
Redness, tenderness or bleeding where the PICC line was inserted or in your arm, neck or chest area
Pain, redness and swelling around the line.
Rashes or any allergic reaction.
If there is ooze under your dressing.
Fever (temperature of 38ºC or higher), feeling hot/cold.
Blocked IV line.
Can I still exercise?
Continuing physical activity during your treatment is good for your general wellbeing. Things to avoid include:
exercise or activities where you repeatedly move your arm, eg, swinging your arm in tennis, golf
water sports or water activities as you need to keep the dressing dry
pulling on your PICC
getting your PICC dressing wet
using sharp objects near your PICC
heavy lifting or repetitive movement (such as vacuuming or mopping) with the arm that has your PICC line in.
How long does my PICC line stay in?
Your PICC can stay in as long as it is needed. This can be weeks, months or longer. When you no longer need your PICC, your nurse will take it out. This is simple and quick. A dressing is placed on your upper arm for 1-2 days until the skin is healed.
Who can I contact if I have any questions?
The home IV antibiotic team will give you a list of people you can contact if you have any problems with your PICC line. In an emergency, you can also contact your GP or Healthline on 0800 611 116.
Image credits: Infusor (Baxter, AUS)