Frequency of Severe Infusion Reactions Associated with Outpatient Infusion of Infliximab without Pre-medications

摘要

In this report, we describe incremental changes, over a two year period at a single center with the administration of maintenance infliximab infusions. Given practice-driven changes consisting of one-hour infusions and omission of pre-medications, we aimed to investigate if these changes contributed to severe infusion reactions. We reviewed approximately 900infliximab infusions in a pediatric ambulatory infusion center from January 1, 2014-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 pre-medications. Our findings highlight a quality-improvement opportunity to standardize infliximab infusions to streamline care in an ambulatory setting.