Home intravenous antibiotics

Hospital In The Home (HITH)

New and existing referrals

For new referrals and existing Home Intravenous Antibiotics (HITH) patients, contact the Home Care Coordinator at the Lady Cilento Children’s Hospital (LCCH) on 0432 003 030.

HITH referrals

Referrals to HITH are via the online CHQ At Home Treatment Plan and Referral Form (QH staff only), view the Hospital In the Home : Referral Flow Sheet (QH staff only) for more information on how to complete the form.

CHQ At Home Treatment form informaton

  • All fields are mandatory but are separated with Medical and Nursing/Care Manager responsibilities.
  • Email all referrals to LCCH_HITH@health.qld.gov.au to be accepted into the program.
  • All home parenteral antimicrobial therapy requires Infectious Diseases Approval prior to making (HITH) referral excluding:
    • CF patients receiving Tobramycin and Piperacillin/Tazobactam for (HITH) OR
    • non-CF bronchiectasis patients receiving Ceftriaxone- see LCCH Antimicrobial Formulary.
  • Written confirmation of Infectious Diseases approval needs to accompany (HITH) referral form

CHQ At Home documents (QH staff only)

Other documents:

For information on the suitability of specific antimicrobials for home intravenous use are listed in the table below. Please contact the HITH/Day hospital Pharmacist for advice on parenteral antimicrobial suitability for HITH: (07) 3068 4967.

Optimal conditions for delivering antimicrobial therapy for HITH

Factors you should consider when delivering antimicrobial therapy within a home environment are:

  • safety
  • drug stability
  • ambient temperature
  • type of intravenous access
  • administration device (springfusor and/or elastomeric device).

Consult the ID team for advice on HITH antimicrobial choice and duration of therapy.

Contact your clinical/ward pharmacist for advice on drug stability and suitable administration device/method.

Paediatric dosing information

For more information on paediatric dosing, administration and monitoring of HITH antimicrobial therapy, refer to:

AntimicrobialsHITH suitability , suggested IV dosing schedule and type of IV access required
AciclovirNot suitable for HITH - seek ID team and pharmacist advice.
PICC line or CVAD required. Not suitable for administration via PIVC.
AmikacinSuitable for HITH
Administer once daily (infuse over 30minutes)
Seek ID team and pharmacist advice on dosing and therapeutic drug monitoring.
Peripheral IV canula (PIVC) or CVAD.
Note: For HITH treatment >7days, PICC line or CVAD required.
AmpicillinNot suitable for HITH.
Not stable at room temperature as 24-hour continuous infusion.
Seek ID team advice for alternative treatment option.
AmoxycillinNot suitable for HITH.
Not stable at room temperature as 24-hour continuous infusion.
Seek ID team advice for alternative treatment option.
Amoxycillin/ClavulanateNot suitable for HITH.
Not stable at room temperature as 24-hour continuous infusion
Seek ID team advice for alternative treatment option.
Amphotericin (liposomal)Seek ID team and pharmacist advice.
Administer once daily (infuse over 60minutes or longer)
PICC line or CVAD required.
AnidulafunginSuitable for HITH.
Once daily (infuse over 60 minutes or longer – max infusion rate of 1.1mg/minute)
Peripheral IV canula (PIVC) or CVAD.
Note: For HITH treatment >7days, PICC line or CVAD required.
AzithromycinNot suitable for HITH.
Seek ID team advice for alternative treatment option.
AztreonamSuitable for HITH.
24-hour continuous infusion (infused via elastomeric device).
PICC line or CVAD required. Not suitable for administration via PIVC.
Benzylpenicillin
(with citrate buffer)
Suitable for HITH.
24-hour continuous infusion (infused via elastomeric device - prepared with citrate buffer).
PICC line or CVAD required. Not suitable for administration via PIVC.
CaspofunginSuitable for HITH.
Administer once daily (infused over 1 hour)
Seek ID team and pharmacist advice.
PICC line or CVAD required. Not suitable for administration via PIVC.
CefepimeSuitable for HITH.
Seek pharmacist advice on drug stability >25 degrees celcius.
24-hour continuous infusion (infused via elastomeric device)
PICC line or CVAD required. Not suitable for administration via PIVC.
CefotaximeSuitable for HITH (Note: Alternative treatment option available- seek ID team advice)
24-hour continuous infusion (infused via elastomeric device)
PICC line or CVAD required. Not suitable for administration via PIVC.
CefoxitinSuitable for HITH.
24-hour continuous infusion (infused via elastomeric device)
PICC line or CVAD required. Not suitable for administration via PIVC.
CeftazidimeNot suitable for HITH.
Not stable at room temperature as 24-hour continuous infusion
Seek ID team advice for alternative treatment option.
CeftriaxoneSuitable for HITH.
Once daily (infuse over 30minutes)
Peripheral IV canula (PIVC) or CVAD.
Note: For HITH treatment >7days, PICC line or CVAD required.
Cephazolin
(Cefazolin)
Suitable for HITH.
24-hour continuous infusion (infused via elastomeric device).
PICC line or CVAD required. Not suitable for administration via PIVC.
ErtapenemSuitable for HITH.
Twice daily dosing (infused via springfusor over 30minutes).
Seek ID team advice on appropriate dosing regimen.
Peripheral IV canula (PIVC) or CVAD.
Note: For HITH treatment >7days, PICC line or CVAD required.
Flucloxacillin
(with citrate buffer)
Suitable for HITH.
24-hour continuous infusion (infused via elastomeric device - prepared with citrate buffer).
PICC line or CVAD required. Not suitable for administration via PIVC.
GanciclovirSeek ID team and pharmacist advice.
CYTOTOXIC agent. PICC line or CVAD required. Not suitable for administration via PIVC.
GentamicinSuitable for HITH.
Once daily (infuse over 30minutes).
Seek ID team and pharmacist advice on dosing and therapeutic drug monitoring.
Peripheral IV canula (PIVC) or CVAD.
Note: For HITH treatment >7days, PICC line or CVAD required.
Imipenem-cilastatinNot suitable for HITH.
Not stable at room temperature as 24-hour continuous infusion
Seek ID team advice for alternative treatment option.
LincomycinNot suitable for HITH.
Seek ID team advice for alternative treatment option.
(No current stability data for continuous infusion in elastomeric device)
MeropenemNot suitable for HITH.
Not stable at room temperature as 24-hour continuous infusion
Seek ID team advice for alternative treatment option.
MicafunginSuitable for HITH.
Once daily (infuse over at least 60 minutes)
PICC line or CVAD required.
Piperacillin/TazobactamSuitable for HITH.
24-hour continuous infusion (infused via elastomeric device).
PICC line or CVAD required. Not suitable for administration via PIVC.
TeicoplaninSuitable for HITH.
Once daily (infuse over 5 to 30minutes).
Peripheral IV canula (PIVC) or CVAD.
Note: For HITH treatment >7days, PICC line or CVAD required.
TobramycinSuitable for HITH.
Administer once daily (infuse over 30minutes).
Seek ID team and pharmacist advice on dosing and therapeutic drug monitoring.
Peripheral IV canula (PIVC) or CVAD.
Note: For HITH treatment >7days, PICC line or CVAD required.
VancomycinSuitable for HITH.
24-hour continuous infusion (infused via elastomeric device).
Seek ID team and pharmacist advice on dosing and therapeutic drug monitoring.
PICC line or CVAD required. Not suitable for administration via PIVC.
VoriconazoleNot suitable for HITH.
Seek ID team advice for alternative treatment option.
(No current stability data for continuous infusion in elastomeric device)
Intravenous medicationDosage
Sodium Chloride 0.9% flush5-10 mL IV PRN
Short term heparin lock (<24hours)(Heparinised saline 50 units in 5mL)
Use 1 to 4mL** IV PRN as a short term heparin lock
(volume is dependent on type of device - see table 1 below)
Long term heparin lock (>24hours)
(Caution: Not to be used for haemophilia patients)


Dilute 1mL of 1000 units/mL Heparin with 9mL Sodium Chloride 0.9%.
(final concentration of 100units/mL heparin)
Use 1 to 4mL** IV PRN as along term heparin lock
(volume is dependent on type of device - see table 1 below)
Cetirizine (Zyrtec)

(in the event of allergic reaction)
Chart as PRN order

1 to 2 years of age
0.25 mg/kg/dose (up to 2.5mg/dose), twice daily PO

2 to 5 years of age
5 mg, daily PO
(can divide into 2 doses)

6 to 12 years of age
10 mg, daily PO
(can divide into 2 doses)
Adrenaline (Epipen®)

(Intramuscular Injection)
(in the event of anaphylaxis)
Chart as a once only PRN order

If less than 20 kg: Give 150 microgram as intramuscular injection

If more than 20 kg: Give 300 microgram as intramuscular injection

NB. Quantify indications for administration under order
Source: CHQ Procedure: Allergic Reaction Emergency Management in Children
CHQ-PROC-01039 Medication – Administration
DeviceApproximate volume of lumen
Tunnelled Cuffed Central Venous Catheter2mL
Peripherally inserted central venous catheter (PICC)1mL
Totally implantable Venous port Device4mL
Source:CHQ Procedure 03450: Intravascular access device management (peripheral and central venous access devices) (QH staff only).

Other HITH interventions include:

  • Naso-gastric tube management
  • Subcutaneous medication (e.g. G-CSF)
  • Skin/wound/eczema care/dressings
  • Physiotherapy
  • Diabetes education/management
  • Respiratory/cardiac assessments
  • Oximetry
  • Hydration assessments, rehydration and others.