Abstract:
Background: Cefazolin elastomeric infusers are commonly used in outpatient settings with peripherally inserted central catheters (PICCs) or mid-line catheters to treat various infections. However, data on the safety of cefazolin elastomeric infusers administered via a peripheral IV catheter (PIVC) are limited.
Objectives: To assess the safety and complications of outpatient cefazolin elastomeric infusers via PIVC.
Methods: A retrospective case series study was conducted, reviewing patients treated with cefazolin elastomeric infuser via PIVC between January 2018 and December 2022 in our institution. The primary outcomes assessed were PIVC-related complications using visual infusion phlebitis (VIP) score, including catheter-related bacteraemia and readmissions within 30 days.
Results: A total of 415 patients aged ≥18 years were treated with cefazolin elastomeric infuser through PIVC during the 5 year study period. On average, each patient required two PIVCs during outpatient treatment, amounting to 870 PIVCs in total. Of these, 85% (n = 352) of patients received cefazolin 6 g daily. The majority were treated for cellulitis (83%) with a median duration of 5 days. No complications (VIP score = 0) were observed in 88.3% (n = 768) of catheters. The incidence of VIP scores of 1, 2 and ≥3 was 8.9% (n = 37), 4.1% (n = 17) and 0% (n = 0), respectively. There were no statistically significant differences in age, sex, comorbidity or diagnosis between participants with a VIP score of 0 and those with a VIP score of ≥1. The incidence of complications including catheter leakage, blockage and dislodgement was low (2.3%, 1.6% and 2%, respectively).
Conclusions: Outpatient cefazolin elastomeric infusers administered via PIVC were well tolerated and safe.
Reference:Chan H, Joseph S, Tran F, Dotel R, Ngian VJJ, Ong BS. Safety and efficacy of continuous cefazolin infusion via peripheral intravenous catheter (PIVC) for outpatient therapy: a brief report. JAC Antimicrob Resist. 2025 Sep 23;7(5):dlaf169. doi: 10.1093/jacamr/dlaf169. PMID: 40995024; PMCID: PMC12455190.