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The MOBILISE study: utilisation of ambulatory pumps in the inpatient setting to administer continuous antibiotic infusions—a randomised controlled trial

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Abstract

In the inpatient setting, antibiotics are generally administered via bedside pumps with multiple daily dosing. Utilisation of a continuous antibiotic infusion (CAI) instead might have patient and nursing satisfaction, workflow efficiencies and infection control benefits. We aimed to study the utilisation of CAI in the inpatient setting for routine antibiotic administration. Patients receiving a peripherally inserted central venous catheter (PICC) for antibiotic administration were screened for the study. The patients were randomised to either (1) standard pump and intermittent antibiotic administration (IAA) or (2) CAI via an ambulatory pump. An accelerometer placed on the ankle was used to assess patient activity. Nursing and patient satisfaction surveys were also carried out. Forty patients met the study criteria for enrolment with 21 patients being enrolled in the CAI arm of the study. One hundred and five days of accelerometer recordings were available for analysis. The geometric mean activity was 45 min/day in the standard arm and 64 min/day in the CAI arm. This represented a 42% (95% CI: −14 to 133%, p = 0.16) difference in activity between the two groups. Nursing staff reported that they spent less time throughout their shift attending the antibiotic line or pump in patients who were in the CAI arm of the study (p < 0.001). In addition, patients in this arm of the study were more likely to recommend this method of administration of antibiotics to a family member (p =0.0001). The MOBILISE study showed nursing and patient satisfaction when CAI were utilised in the inpatient setting. A statistically non-significant difference in mobility was seen. The trial was registered (28/03/2018) with the Australia New Zealand Clinical Trials Registry (ACTRN12618000452291).

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Data availability

The datasets generated during the current study are available from the corresponding on reasonable request.

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Acknowledgements

The authors acknowledge Ian Smith, Grace Babiano, Lisa Caufield, Margarette Sommerville, Kim Ta, Chris Accornero, Barbara Hewer and the VASE (Vascular access) team at the RBWH for their assistance with this study and the Royal Brisbane and Women’s Hospital Research Foundation for the project grant awarded to fund the study.

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Funding

A project grant from the Royal Brisbane and Women’s Hospital Research Foundation was awarded to fund this study.

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Authors and Affiliations

  1. Infectious Diseases Department, Level 6 Joyce Tweddell Building, Royal Brisbane and Women’s Hospital, Cnr Butterfield St and Herston Road, Brisbane, QLD, 4029, Australia

    K. L. McCarthy, A. Legg & D. L. Paterson

  2. University of Queensland Centre for Clinical Research, Brisbane, QLD, Australia

    K. L. McCarthy, T. Harris-Brown, M. D. Chatfield & D. L. Paterson

  3. RECOVER Injury Research Centre, University of Queensland, Brisbane, QLD, Australia

    E. J. Smits

Authors
  1. K. L. McCarthy
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  2. T. Harris-Brown
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  3. E. J. Smits
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  4. A. Legg
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  5. M. D. Chatfield
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  6. D. L. Paterson
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Contributions

Conceptualisation and design: KM, THB, AL, and DP. Data collection: KM, THB, and ES. Analysis and interpretation of data: KM, ES, and MC. Drafting the article or revising it critically for intellectual content: KM, THB, ES, AL, MC, and DP. Final version of the version to be submitted: KM, MC, and DP.

Corresponding author

Correspondence to K. L. McCarthy.

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Ethics approval

The study was performed in line with the principals of the Declaration of Helsinki. Approval was granted by the RBWH Human Research and Ethics Committee.

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Informed consent was obtained from all individual participants included in the study.

Conflict of interest

DP has relevant financial activities outside the submitted work. The other authors declare no competing interests.

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McCarthy, K.L., Harris-Brown, T., Smits, E.J. et al. The MOBILISE study: utilisation of ambulatory pumps in the inpatient setting to administer continuous antibiotic infusions—a randomised controlled trial. Eur J Clin Microbiol Infect Dis 40, 2505–2513 (2021). https://doi.org/10.1007/s10096-021-04294-3

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  • DOI: https://doi.org/10.1007/s10096-021-04294-3

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