Frequency of Severe Infusion Reactions Associated With Outpatient Infusion of Infliximab Without Premedications. Issue 4 (October 2017)

• Record Type: Journal Article
• Authors: Hutsell, Stephanie Q.; Wu, May; Park, K.T.
• Is Part Of: Journal of pediatric gastroenterology and nutrition. Volume 65:Issue 4(2017)
• Publication Date: 2017-10
• Subjects: adverse reaction -- infliximab -- pediatric -- premedications -- rapid infusion; Children -- Nutrition -- Periodicals; Pediatric gastroenterology -- Periodicals; Infants -- Nutrition -- Periodicals; Nutrition disorders in children -- Periodicals; Child Nutrition -- Periodicals; Digestive System -- growth & development -- Periodicals; Gastrointestinal Diseases -- Periodicals; Infant Nutrition -- Periodicals; Nutrition Disorders -- Periodicals; Child; 618.923
• DOI: 10.1097/MPG.0000000000001535
• Languages: English
• ISSNs: 0277-2116

Abstract

Abstract : ABSTRACT: In this report, we describe incremental changes, during a 2-year period at a single center with the administration of maintenance infliximab infusions. Given practice-driven changes consisting of 1-hour infusions and omission of premedications, we aimed to investigate if these changes contributed to severe infusion reactions. We reviewed approximately 900 infliximab infusions in a pediatric ambulatory infusion center from January 1, 2014, to December 31, 2015, for severe adverse reactions requiring either rescue epinephrine or a code blue or "rapid response" activation. In 2015, these practice changes resulted in a 51% decrease in total infusion hours (1281 to 630 infusion hours), despite a 9% increase in total number of infusions. No increase in severe adverse events associated with either rapid 1-hour infusion or omission of premedications. Our findings highlight a quality-improvement opportunity to standardize infliximab infusions to streamline care in an ambulatory setting.