Temperature profiles of antibiotic-containing elastomeric infusion devices used by ambulatory care patients

Abstract

PURPOSE: The temperature profiles of antibiotic-containing elastomeric infusion devices used by ambulatory care patients under various environmental conditions were evaluated. METHODS: A prospective, descriptive survey of temperature exposure was conducted in 4 publically funded hospitals. Over a 12-month period, electronic temperature-recording devices were attached to the antibiotic infusion devices (infusers) of prospectively randomized hospital-in-the-home (HITH) participants. Temperatures were recorded immediately after infuser connection and every 5 minutes thereafter for 24 hours. A structured data collection form was used to collect information on basic clinical and demographic characteristics and aspects of daily living (i.e., how and where the infuser was carried during the day, times the participant went to and arose from bed, location of the infuser while sleeping, and dates and times the infuser was connected and disconnected). RESULTS: A total of 115 patients successfully completed the study (17-91 years old, 55% males). A total of 31,298 temperature readings were collected. The storage location of the infuser did not influence daytime readings. However, the overnight storage location did have a significant impact on the temperatures recorded overnight. The mean temperatures of infusers stored on the bed or on the body overnight were significantly higher than those for infusers stored away from the bed. Diurnal and seasonal influences were also detected. Significantly warmer temperatures were recorded in afternoons and evenings and during the summer months. CONCLUSION: Antibiotics administered to HITH patients via continuous infusion were frequently exposed to temperatures in excess of 25 degrees C. Specific patient behaviors and seasonal and chronological factors influenced temperatures. The findings challenge the validity of current fixed-temperature models for testing stability, which do not reflect conditions found in clinical practice.